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|本期目录/Table of Contents|

稳定型心绞痛患者对阿司匹林的反应性

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2010年第2期
页码:
237-239,243
栏目:
临床研究
出版日期:
2010-03-04

文章信息/Info

Title:
Clinical study on platelet reactivity in patients with stable angina
作者:
翟东东高炬王斌
北京大学航天临床医学院心内科,北京 100049
Author(s):
ZHAI Dong-dong GAO Ju WANG Bin
Department of Cardiology, College of Clinical Aerospace Medicine, Peking University, Beijing 100049, China
关键词:
血栓弹力图血小板反应性血栓前状态C反应蛋白
Keywords:
thrombelastograph platelet reactivity prothrombotic status C-reactive protein
分类号:
R5414
DOI:
-
文献标识码:
A
摘要:
目的: 探讨在冠心病患者中,阿司匹林的个体差异及相关因素。方法: 稳定型心绞痛患者100例,服拜阿司匹林100 mg/d,7 d后测定血栓素B2(TXB2)、6-酮-前列腺素F1α(6-keto-PGF1α)、D-二聚体(D-D)、纤维蛋白原(FIB)、同型半胱氨酸(HCY)及C反应蛋白(CRP)水平,同时使用血栓弹力仪测定血小板的反应性,并根据反应性不同将患者分为四分位组(高反应性组和低反应性组),观察两组患者的临床特征。结果: 血小板反应性呈正态分布;高反应性的患者中女性(52% vs.28%,P<0.05)及糖尿病患者(64% vs.32%,P<0.05)的比例较高;血栓前状态标记物中TXB2[(102±17)ng/L vs.(74±17)ng/L,P<0.05]及CRP[(7.7±1.6)mg/L vs.(4.3±1.2)mg/L,P<0.05]在血小板高反应性的患者中高于低反应性组。结论: 冠心病患者血小板反应性存在个体差异。
Abstract:
AIM: To investigate the platelet reactivity in patients with coronary heart disease (CHD). METHODS: One hundred stable angina patients were given aspirin (100 mg, once daily) for 7 days. Thromboxane B2 (TXB2), 6-keto-prostaglandin F1α (6-6-keto-PGF1α), D-dimer (D-D), fibrinogen (FIB), homocysteine (HCY), and C-reactive protein (CRP) levels were then measured. The platelet reaction was measured by thrombelastograph (TEG). Patients were divided into high-platelet reaction groups (HPR) and low-platelet reaction groups (LPR). RESULTS: Platelet reactions were normally distributed. Females and patients with diabetes had higher platelet reactivity compared with males (52% vs. 28%, P<0.05) and patients without diabetes (64% vs. 32%, P<0.05). The prothrombotic status marker TXB2 [(102±17) ng/L vs.(74±17) ng/L, P<0.05] and CRP [(7.7±1.6) mg/L vs.(4.3±1.2) mg/L, P<0.05] were higher in HPR patients. CONCLUSION: Platelet reactivity in CHD patients has demonstrated some individual differences.

参考文献/References

[1] Eikelboom JW, Hankey GJ. Aspirin resistance: a new independent predictor of vascular events?[J]. J Am Coll Cardiol, 2003, 41(6):966-968.

[2] Tantry US, Bliden KP, Gurbel PA. Overestimation of platelet aspirin resistance detection by thrombelastograph platelet mapping and validation by conventional aggregometry using arachidonic acid stimulation[J]. J Am Coll Cardiol, 2005, 46(9):1705-1709.

[3] Carroll RC, Craft RM, Chavez JJ, et al. A Thrombelastograph whole blood assay for clinical monitoring of NSAID-insensitive transcellular platelet activation by arachidonic acid[J]. J Lab Clin Med, 2005, 146(1):30-35.

[4] Gum PA, Kottke-Marchant K, Welsh P, et al. A prospective, blinded determination of the natural history of aspirin resistance among stable patients with cardiovascular disease[J]. J Am Coll Cardiol, 2003, 41(6):961-965.

[5] Chen WH, Lee PY, Ng W, et al. Aspirin resistance is associated with a high incidence of myonecrosis after nonurgent percutaneous coronary intervention despite clopidogrel pretreatment[J]. J Am Coll Cardiol, 2004, 43(6):1122-1126.

[6] Ridker PM, Cook NR, Lee IM, et al. A randomized trial of low-dose aspirin in the primary prevention of cardiovascular disease in women[J]. N Engl J Med, 2005, 352(13):1293-1304.

[7] Watala C, Golanski J, Pluta J, et al. Reduced sensitivity of platelets from type 2 diabetic patients to acetylsalicylic acid (aspirin)-its relation to metabolic control[J]. Thromb Res, 2004, 113(2):101-113.

[8] Tamminen M, Lassila R, Westerbacka J, et al. Obesity is associated with impaired platelet-inhibitory effect of acetylsalicylic acid in nondiabetic subjects[J]. Int J Obes Relat Metab Disord, 2003, 27(8):907-911.

[9] Serebruany VL, Glassman AH, Malinin AI, et al. Platelet/endothelial biomarkers in depressed patients treated with the selective serotonin reuptake inhibitor sertraline after acute coronary events: the Sertraline AntiDepressant Heart Attack Randomized Trial (SADHART) Platelet Substudy[J]. Circulation, 2003, 108(8): 939-944.

[10]Oltrona L, Ardissino D, Merlini PA, et al. C-reactive protein elevation and early outcome in patients with unstable angina pectoris[J]. Am J Cardiol, 1997, 80(8):1002-1006.

备注/Memo

备注/Memo:
收稿日期:2008-5-4.通讯作者:王斌,主任医师,主要从事冠心病及心律失常的介入治疗Binwang@yahoo.com.cn 作者简介:翟东东,硕士生Email:ddzhai@yahoo.com.cn
更新日期/Last Update: 2010-03-05