CAJ | 학술논문

目的探讨血栓弹力图评价服用不同剂量阿司匹林对血小板抑制率的影响.方法将符合入选条件的缺血性脑卒中或短暂性脑缺血发作(TIA)患者180例按就诊顺序随机分为阿司匹林100 mg/d组、阿司匹林200 mg/d组、阿司匹林300 mg/d组,每组60例,在服药前及服药后7d、6个月、1年应用血栓弹力图检测花生四烯酸途径诱导的血小板抑制率并进行比较.结果三组服药后各时间点血小板抑制率与服药前比较差异有统计学意义(P＜0.05).服药后阿司匹林100 mg/d组和阿司匹林200 mg/d组血小板抑制率呈逐步减低趋势,而阿司匹林300 mg/d组呈轻度递增趋势.三组服药前、服药后7d、服药后6个月血小板抑制率比较差异均无统计学意义(P＞0.05),而服药后1年比较差异有统计学意义(P＜0.05),两两比较阿司匹林300 mg/d组血小板抑制率[(93.8±18.6)％]显著高于阿司匹林200 mg/d组[(83.7±11.2)％]和阿司匹林100 mg/d组[(76.6±12.8)％](P＜0.05).阿司匹林100 mg/d组血小板抑制率低于50％者9例,阿司匹林200 mg/d组5例,阿司匹林300 mg/d组3例,阿司匹林300 mg/d组1年内发生消化道溃疡出血2例.结论适当的阿司匹林剂量(100、200、300 mg/d)均能起到很好的抗血小板作用,在100 mg/d基础上增加剂量血小板抑制率在短期内(≤6个月)未见明显增加,但长期(1年)存在差异,可能与阿司匹林抵抗发生较少有关,而出血风险却相对增大.
목적 탐토혈전탄력도평개복용불동제량아사필림대혈소판억제솔적영향.방법 장부합입선조건적결혈성뇌졸중혹단잠성뇌결혈발작(TIA)환자180례안취진순서수궤분위아사필림100 mg/d조、아사필림200 mg/d조、아사필림300 mg/d조,매조60례,재복약전급복약후7d、6개월、1년응용혈전탄력도검측화생사희산도경유도적혈소판억제솔병진행비교.결과 삼조복약후각시간점혈소판억제솔여복약전비교차이유통계학의의(P＜0.05).복약후아사필림100 mg/d조화아사필림200 mg/d조혈소판억제솔정축보감저추세,이아사필림300 mg/d조정경도체증추세.삼조복약전、복약후7d、복약후6개월혈소판억제솔비교차이균무통계학의의(P＞0.05),이복약후1년비교차이유통계학의의(P＜0.05),량량비교아사필림300 mg/d조혈소판억제솔[(93.8±18.6)％]현저고우아사필림200 mg/d조[(83.7±11.2)％]화아사필림100 mg/d조[(76.6±12.8)％](P＜0.05).아사필림100 mg/d조혈소판억제솔저우50％자9례,아사필림200 mg/d조5례,아사필림300 mg/d조3례,아사필림300 mg/d조1년내발생소화도궤양출혈2례.결론 괄당적아사필림제량(100、200、300 mg/d)균능기도흔호적항혈소판작용,재100 mg/d기출상증가제량혈소판억제솔재단기내(≤6개월)미견명현증가,단장기(1년)존재차이,가능여아사필림저항발생교소유관,이출혈풍험각상대증대.
Objective To evaluate the effect of different doses of aspirin on the platelet inhibition rate by thremboelastography.Methods One hundred and eighty patients with ischemic stroke or transient cerebral ischemic attack (TIA) were randomly divided into aspirin 100 mg/d group (60 patients),aspirin 200 mg/d group (60 patients) and aspirin 300 mg/d group (60 patients) according to the order of treatment.The platelet inhibition rate which arachidonic acid pathway induced was measured by thromboelastography and compared at different time points (before medication; 7 days,6 months,1 year after medication).Results There were significant differences in the platelet inhibition rate after medication at different time points compared with that before medication in three groups (P ＜ 0.05).After medication at different time points,the platelet inhibition rate of aspirin 100 mg/d group and aspirin 200 mg/d group was gradually decreasing.On the contrary,that of the aspirin 300 mg/d group showed gradually increasing.Cross-sectional comparison of the three groups at different time points showed that there was no significant difference in the platelet inhibition rate among three groups before medication,7 days,6 months after medication (P ＞ 0.05).However,there was significant difference at 1 year after medication (P ＜ 0.05).The platelet inhibition rate inaspirin 300 mg/d group [(93.8 ± 18.6)％] was higher than that in aspirin 200 mg/d group [(83.7 ± 11.2)％]and aspirin 100 mg/d group [(76.6 ± 12.8)％] (P ＜ 0.05).During medication there were 9 patients of less than 50％ platelet inhibition rate in aspirin 100 mg/d group,5 patients in aspirin 200 mg/d group,3 patients in aspirin 300 mg/d group,and 2 patients of peptic ulcer bleeding in aspirin 300 mg/d group.Conclusions The appropriate dose of aspirin (100,200,300 mg/d) can play a very good anti-platelet effect.Increasing the dose on the basis of 100 mg/d,the platelet inhibition rate shows no increase in the short-term (≤6 months),but in the long-term (1 year) there may be differences.It may be associated with less aspirin resistance and the relative increasing bleeding risk.