CAJ | 학술논문

目的:了解非体外循环冠状动脉旁路移植术(OPCAB)后患者阿司匹林抵抗(AR)发生情况.方法:60例患者接受OPCAB手术,术前常规停用阿司匹林5～7 d,术后服用阿司匹林100mg/d,分别于术前、术后服药后第1天、4天以及10天检测花生四烯酸诱导的血小板聚集率,同时记录患者各项临床资料.结果:60例患者中,服用阿司匹林后第1天存在AR者17例(28.3%),第4天存在AR者9例(15%),第10天存在AR者2例(3.3%);术前及服用阿司匹林后第1、4、10天,60例患者整体血小板聚集率(%)水平分别为63(52,70)、13(11,22)、12(10,14)及12(11,14),其下降水平在服药4d后趋于稳定;术后未见AR的危险因素.结论:OPCAB术后早期,阿司匹林抗血小板聚集的作用受到抑制,部分患者出现AR,这一时期予以更为积极的抗凝及抗血小板聚集治疗有重要临床意义.
목적:료해비체외순배관상동맥방로이식술(OPCAB)후환자아사필림저항(AR)발생정황.방법:60례환자접수OPCAB수술,술전상규정용아사필림5～7 d,술후복용아사필림100mg/d,분별우술전、술후복약후제1천、4천이급10천검측화생사희산유도적혈소판취집솔,동시기록환자각항림상자료.결과:60례환자중,복용아사필림후제1천존재AR자17례(28.3%),제4천존재AR자9례(15%),제10천존재AR자2례(3.3%);술전급복용아사필림후제1、4、10천,60례환자정체혈소판취집솔(%)수평분별위63(52,70)、13(11,22)、12(10,14)급12(11,14),기하강수평재복약4d후추우은정;술후미견AR적위험인소.결론:OPCAB술후조기,아사필림항혈소판취집적작용수도억제,부분환자출현AR,저일시기여이경위적겁적항응급항혈소판취집치료유중요림상의의.
Objective:To assess aspirin efficacy in the early postoperative period following off-pump coronary artery bypass(OPCAB)surgery.Methods:Sixty patients undergoing OPCAB surgery were enrolled in the study.Previous aspirin treatment Was terminated 5-7 days before OPCAB and continued to take at the day with food intake after surgery.The functional and biochemical responses to aspirin were evaluated by arachidonie acid (ARA)-induced platelet aggregation.Samples were collected before and on days 1,4 and 10 after aspirin intake(100 mg/d).Results:There were 17 patients(28.3%),9 patients (15%)and 2 patients(3.3%)with aspirin resistance on day 1,4 and 10 of aspirin intake.The overall levels of platelet aggregation(%)were 63(52,70),13(11,22),12(10,14),and 12(11,14)before the surgery and on day 1,4 and 10 of aspirin intake.The level was stable from the 4th day after aspirin intake.It was found that aspirin resistance was not an independent risk factor for the operation.Conclusion:Aspirin did not sufficiently inhibit platelet aggregation at the early stage after OPCAB.It is important to keep potential anti-coagulation therapy in the early postoperative period.