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美洛昔康与小剂量阿司匹林联用对心血管病患者前列环素-血栓烷A2平衡的影响(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2005年第4期
页码:
376-379,382
栏目:
临床研究
出版日期:
2005-09-05

文章信息/Info

Title:
Influence of combined therapy of selective cyclooxygenase2inhibitor Meloxicam and lowdose Aspirin on prostacyclinthromboxane A2 balance of cardiovascular patients
作者:
谭真1; 黄德嘉1; 张敏2; 李强2
四川大学：1.华西医院心内科；2.基础与法医学院同位素教研室，四川 成都 610044
Author(s):
TAN Zhen1;  HUANG Dejia1;  ZHANG Min2;  LI Qiang2
1.Department of Cardiology, West China Hospital; 2. Staff Room of Isotopy, Basic and Forensic School, Sichuan University, Chengdu, Sichuan 610044，China
关键词:
阿司匹林; 美洛昔康; 前列环素－血栓烷A2平衡
Keywords:
Aspirin;  Meloxicam;  prostacyclinthromboxane A2 balance
分类号:
R541.4;R541.3
DOI:
-
文献标识码:
A
摘要:
目的 前列环烷（PGI2）血栓烷A2（TXA2）平衡对维持机体抗血栓促血栓作用间平衡有重要意义，本研究旨在探讨选择性环氧化酶2抑制剂美洛昔康与小剂量阿司匹林联用对心血管病患者PGI2TXA2平衡的影响。方法 选择20例原发性高血压及冠心病患者为研究对象。入选后均口服阿司匹林肠溶片75 mg/d，7 d。自第8天起随机分为两组，一组继续口服阿司匹林肠溶片75 mg/d（第1组，n=10），另一组口服阿司匹林肠溶片75 mg/d及美洛昔康7.5 mg/d（第2组，n=10），均连服4 d。于服药后第8天晨及第12天晨取静脉血，测定PGI2和TXA2的稳定代谢产物6酮PGF1α和TXB2，同时测定血小板聚集性。结果 ①两组患者血浆TXB2，血清TXB2，血清6酮PGF1α，血小板最大聚集率及血小板聚集速率无显著性差异（P>0.05）。②第2组患者血清PGF1α/TXB2比值用药后有下降趋势（P=0.056），第1组患者血清PGF1α/TXB2比值无明显变化（P=0.799）。③第2组中冠心病患者血清PGF1α/TXB2比值联用药后显著下降（P<0.05），第1组中冠心病患者血清PGF1α/TXB2比值前、后两次比较无显著性差异（P>0.05）。结论 心血管病患者联合使用选择性环氧化酶2抑制剂美洛昔康（7.5 mg/d）和小剂量阿司匹林（75 mg/d）后血清PGF1α/TXB2比值下降，这一影响在冠心病患者中尤为显著，反映其使心血管病患者PGI2TXA2平衡向促血栓形成方向倾斜。
Abstract:
AIM The balance between biosynthesis of prostacyclin（PGI2）and thromboxane A2（TXA2）has been proved to be important in the prevention of thrombosis. The present study was to investigate the influence of combined therapy of selective cyclooxygenase2 inhibitor Meloxicam and lowdose Aspirin on PGI2TXA2 balance of cardiovascular patients. METHODS Twenty hypertensive patients with or without coronary heart disease(CHD) were randomly divided into 2 groups. One was combinedtherapy group whose numbers received entericcoated Aspirin 75 mg/d for 11 days. The other was singletherapy group whose numbers received entericcoated Aspirin 75 mg/d for 7 days and entericcoated Aspirin 75 mg/d with Meloxicam 7.5 mg/d for the next 4 days. The metabolic products of PGI2 and TXA2 (6ketoPGF1αand TXB2 respectively) were determined by radioimmunoassay of patients’ fast blood on the eighth and the twelfth morning. Platelets aggregation was also measured. RESULTS ①The two groups had no significant difference in 6ketoPGF1α,TXB2, maximal platelets aggregation rate and aggregation slope on the eighth morning and on the twelfth morning（P>0.05）. ②There was a trend toward lower ratio of serum 6ketoPGF1α to TXB2 after combined therapy of Aspirin and Meloxicam whereas there was no such trend in the singletherapy group（P=0.056 and 0.799 respectively）. ③The ratio of patients with CHD in the combinedtherapy group decreased significantly after combined therapy（P<0.05）,while patients with CHD in the singletherapy group had no significant change in the ratio（P>0.05）. CONCLUSION Combined therapy of selective cyclooxygenase2 inhibitor Meloxicam (7.5 mg/d) and Aspirin(75 mg/d) in cardiovascular patients, especially in patients with CHD, lowered the ratio of serum 6ketoPGF1α to TXB2, indicating that the PGI2TXA2 balance is shifted toward a more prothrombotic direction.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：2004-12-01.
更新日期/Last Update: 2010-01-05