CAJ | 학술논문

　　目的研究普外长期服用阿司匹林择期手术患者术前停药的合理时限及术后恢复对血小板功能的影响。方法将121例普外科择期手术患者（试验组）根据术前阿司匹林停用时间分为停药5 d组59例和7 d组62例。另择50例健康体检者为对照组。采用花生四烯酸（AA）诱导血小板聚集试验测定各组血小板聚集率（PAgT），ELISA法测定尿11-脱氢-血栓烷B2（11-DH-TXB2）。于术后24~48 h内恢复使用阿司匹林，测定恢复用药7 d和10 d时5 min PAgT和11-DH-TXB2。结果停药5 d组停药后5 min、8 min和10 min PAgT均低于对照组和停药7 d组（均P<0.05）；停药7 d组与对照组差异无统计学意义。停药5 d时，血小板聚集出现延迟聚集和低程度聚集曲线2种特征，停药7 d时呈正常聚集曲线。试验组术后恢复用药7 d和10 d时5 min PAgT、11-DH-TXB2均低于对照组，恢复用药7 d时水平高于10 d时（均P<0.05）。结论术前停用阿司匹林7 d时患者血小板功能基本恢复正常状态；术后恢复应用阿司匹林对患者实验室监测的时间应延长至7d后。
　　목적연구보외장기복용아사필림택기수술환자술전정약적합리시한급술후회복대혈소판공능적영향。방법장121례보외과택기수술환자（시험조）근거술전아사필림정용시간분위정약5 d조59례화7 d조62례。령택50례건강체검자위대조조。채용화생사희산（AA）유도혈소판취집시험측정각조혈소판취집솔（PAgT），ELISA법측정뇨11-탈경-혈전완B2（11-DH-TXB2）。우술후24~48 h내회복사용아사필림，측정회복용약7 d화10 d시5 min PAgT화11-DH-TXB2。결과정약5 d조정약후5 min、8 min화10 min PAgT균저우대조조화정약7 d조（균P<0.05）；정약7 d조여대조조차이무통계학의의。정약5 d시，혈소판취집출현연지취집화저정도취집곡선2충특정，정약7 d시정정상취집곡선。시험조술후회복용약7 d화10 d시5 min PAgT、11-DH-TXB2균저우대조조，회복용약7 d시수평고우10 d시（균P<0.05）。결론술전정용아사필림7 d시환자혈소판공능기본회복정상상태；술후회복응용아사필림대환자실험실감측적시간응연장지7d후。
Objective To investigate the reasonable time limit for stopping the aspirin treatment in preoperative pa-tients with general surgery and the effects on platelet function in postoperative patients with recovering the therapy of aspirin. Methods A total of 121 patients undergoing elective general surgery were divided into stopping aspirin treatment 5 d group (n=59) and stopping aspirin treatment 7 d group (n=62). Fifty healthy volunteers were used as the control group. The arachi-donic acid (AA)-induced platelet aggregation test was used to detect the platelet agglutination rate in all groups. Aspirin was reused 24~48 h after surgery. The level of urinary 11-dehydro-thromboxane B2 (11-DH-TXB2) was assayed by ELISA 7 and 10 d after retreatment. Results The levels of the PAgT (5 min, 8 min and 10 min) were decreased significantly in pa-tients with stopping aspirin treatment 5 d group compared with those of patients with stopping aspirin treatment 7 d group and control group (P<0.05). There was no significant difference in the level of PAgT between patients with stopping aspirin treatment 7 d group and control group. The platelet aggregation showed two different characteristic curves after stopping aspi-rin treatment for 5 d. And the normal curve of platelet aggregation was found after stopping aspirin treatment for 7 d. The lev-els of PAgT and urinary 11-DH-TXB2 were significantly lower in patient recovered the aspirin treatment for 7 d and 10 d than that of control, and which was significantly higher in 7 d group than that of 10 d group (P>0.05). Conclusion The platelet aggregative function returned to normal level in patients with 7-d preoperative stopping aspirin. The laboratory moni-toring of aspirin therapy should be more than 7 d after postoperative reusing aspirin.