Comparison between a new platelet count drop method PL-11, light transmission aggregometry,VerifyNow aspirin system and thromboelastography for monitoring short-term aspirin effects in healthy individuals

Platelet function has been described by many laboratory assays, and PL-11 is a new point-of-care platelet function analyzer based on platelet count drop method, which counts platelet before and after the addition of agonists in the citrated whole blood samples. The present study sought to compare PL-11 with other three major more established assays, light transmission aggregometry (LTA), VerifyNow? aspirin system and thromboelastography (TEG), for monitoring the short-term aspirin responses in healthy individuals. Ten healthy young men took 100?mg/d aspirin for 3-day treatment. Platelet function was measured via PL-11, LTA, VerifyNow and TEG, respectively. The blood samples were collected at baseline, 2 hour, 1 day during the aspirin treatment and 1 day, 5?±?1 days, 8?±?1 days after the aspirin withdrawal. Moreover, 90 additional healthy subjects were recruited to establish a reference range for PL-11. Platelet function of healthy subjects decreased significantly 2 hours after 100?mg/d aspirin intake and began to recover during 4–6 days after the aspirin withdrawal. Correlations between methods were PL-11 vs. LTA (r?=?0.614, p?<?0.01); PL-11 vs. VerifyNow (r?=?0.829, p?<?0.01); PL-11 vs. TEG (r?=?0.697, p?<?0.001). There was no significant bias between PL-11 and LTA at baseline (bias?=?1.94%, p?=?0.804) using Bland-Altman analysis, while the data of PL-11 were significantly higher than LTA (bias?=?24.02%, p?<?0.001) during the aspirin therapy. The reference range for PL-11 in healthy young individuals was from 66.8 to 90.5% (95%CI). When aspirin low-responsiveness was defined as LTA?>?20%, the cut-off values for each method were, respectively: PL-11?>?50%, VerifyNow?>?533 ARU, TEG?>?60.2%. The results of different platelet function assays were uninterchangeable for monitoring aspirin response and correlations among them were also varied. Correlations among PL-11 and other three major assays suggested the ability of PL-11 to assess the treatment effects of aspirin. But a large cohort study is needed to confirm the cut-off value of aspirin response detected by PL-11.     

小剂量阿司匹林与银可络联用对老年患者血液流变学异常的影响

目的探讨小剂量阿司匹林与银可络联用对老年患者血液流变学异常的影响。方法57例老年病人并伴有高凝、高粘血症者采用小剂量阿司匹林50mg,口服,1次/d,银可络80mg,口服,3次/d。疗程为1个月。并测定治疗前后血液流变学各项参数。结果病例组治疗后血小板粘附率(PadT)、血栓长度、重量与对照组比较均有显著性差异(P均<0.01);治疗后红细胞刚性指数(IR)、血沉(ESR)、红细胞电泳时间(EFT)、全血表现粘度(BAV)与治疗前比较均有显著性差异(P均<0.001);病例组治疗后红细胞比积(HCT)、纤维蛋白原(Fib)、血浆比粘度(PV)与对照组比较均无显著性差异(P均>0.05)。结论小剂量阿司匹林与银可络联合治疗对血栓形成过程有抑制作用,红细胞变形能力和聚集性有所改善。但对Fib,PV,HCT无影响。     

肠溶阿斯匹林剂量和血阿斯匹林及水杨酸盐浓度与药效关系探讨

本文探讨了ＡＳＡ剂量与药效的关系及血ＡＳＡ、ＳＡ药物浓度监测的临床意义，结果表明：（１）ＡＳＡ剂量与６－ｋｅｔｏ－ＰＧＦ_（１α）抑制率呈正相关（Ｐ＜０．０１），而与ＴＸＢ_２及ＰＡｇＲ抑制率无相关性（Ｐ＞０．１）；（２）本文采用ＨＰＬＣ内标法同时测定血ＡＳＡ和ＳＡ浓度，结果准确，方法简便；（３）当口服小剂量ＡＳＡ防治ＣＩ时，监测血ＡＳＡ和ＳＡ以调整ＡＳＡ用药剂量的临床价值并非十分重要。     

阿司匹林间歇疗法在脑卒中二级预防中的临床价值

目的观察阿司匹林间歇疗法与常规疗法在脑卒中二级预防中临床价值的差异。方法收集250例脑卒中恢复期患者,按随机单盲开放对照原则分为间歇疗法组(间歇组)(每8周内停药1周)和常规疗法组(单规组)各125例,均给予阿司匹林100mg Qd治疗2年。结果(1)2组脑卒中再发率无明显差异;(2)2组患者的血小板聚集率和凝血功能无明显差异;(3)间歇组上消化道出血、腹痛、腹泻等不良反应发生率较常规组明显下降(P<0.01)。结论阿司匹林间歇疗法较常规疗法能有效减低了长期治疗导致的消化道不良反应,同时有效降低脑卒中的再发率,在脑卒中二级预防中具有重要的临床应用价值。     

低剂量阿司匹林在辅助生育技术中的应用

目的　探讨在进行体外受精 -胚胎移植 ( IVF-ET)或卵母细胞浆内单精子注射 ( ICSI)患者口服低剂量阿司匹林对治疗结果的影响。　方法　 IVF或 ICSI治疗的 3 2 4个 ET周期 ,分为是否服用阿司匹林两组 ,分别统计患者注射人绒毛膜促性腺激素 ( h CG)时子宫内膜厚度及 ET胚胎数 ,比较两组的胚胎种植率、临床妊娠率及流产率 ,并进行统计学处理。　结果　两组在注射 h CG日内膜平均厚度、ET中优质胚胎的比率及流产率均无显著性差异 ;未服用阿司匹林组的 ET胚胎数明显多于服用组 ( P<0 .0 1 ) ,而前者的种植率、临床妊娠率却明显低于后者 ( P<0 .0 1 )。　结论　低剂量阿司匹林在 IVF-ET或ICSI的辅助生殖治疗中能有效地提高胚胎种植率 ,增加患者的临床妊娠率     

阿司匹林咀嚼片人体生物等效性研究

目的比较国产阿司匹林咀嚼片与水溶片剂的人体相对生物利用度。方法18名健康受试者进行随机交叉试验设计,分别先后单次口服324mg咀嚼片和300mg阿司匹林水溶片剂,采用高效液相色谱法测定血浆中阿司匹林浓度。结果咀嚼片与参比片剂的AUC0~t分别为(154.41±74.41)、(142.48±70.94)μgml-1h,Cmax分别为(25.83±6.04)、(25.07±5.72)μgml-1,Tmax分别为(0.81±0.33)、(0.79±0.41)h,T1/2分别为(3.43±1.02)、(3.25±1.21)h,供试品生物利用度为(101.09±13.56)%。结论药动学参数经方差分析双向单侧t检验无显著性差异,提示国产阿司匹林咀嚼片与水溶片剂具有生物等效性。     

Who will conceive with IVF?

When considering the chances of establishing a healthy ongoing pregnancy after in vitro fertilization (IVF), the cause of infertility plays a relatively minor role. In recent years, there has been a shift from determining the diagnosis to the individual prognosis for a given patient. A number of prognostic factors were identified, which enabled clinicians to appropriately counsel patients. Patient-determined factors are of crucial importance and some are amenable to intervention such as lifestyle and nutritional advice. However, the attention of clinicians remains on seeking adjuvant therapeutic interventions designed to improve the outcomes of IVF treatment. In this article, the patient-determined factors underlying the individual chance of conceiving and the more commonly prescribed empirical medical therapies prescribed to enhance outcomes are reviewed. It is concluded that greater attention to optimizing the health of the couple before starting IVF treatment may be more beneficial than adjuvant medical therapies during treatment.     

硫酸氢氯吡格雷改善慢性稳定型心绞痛患者阿司匹林抵抗的临床研究

目的研究硫酸氢氯吡格雷（秦嘉）对慢性稳定型心绞痛阿司匹林抵抗患者的治疗价值。方法610例慢性稳定型心绞痛患者依照血小板聚集率分为阿司匹林敏感（AS）者和阿司匹林抵抗（AR）者，将138例AR者随机分为阿司匹林治疗组（AR—A组）、泰嘉治疗组和泰嘉联合阿司匹林治疗组（AR～C组）。472例AS者中随机选取40例设为对照组。4组患者给予严格的药物治疗后随访1年，观察4组患者在治疗前后的血小板聚集率变化，以及治疗后缺血性心脑血管病的发生率和出血性事件的发生率。治疗1月后行12导联24h动态心电图检查，计算24h内缺血型ST段变化的次数、持续时间、心肌缺血总负荷。结果泰嘉可以有效地降低慢性稳定型心绞痛AR患者的血小板聚集率（P〈0．01）；较少发生缺血性心脑血管事件（P〈0．01），且不增加出血事件的发生（P〉0．05）。对存在AR的慢性稳定型心绞痛患者，单用泰嘉和联合服用阿司匹林治疗，其缺血性ST段变化的次数、持续时间及心肌缺血总负荷明显低于单用阿司匹林治疗（P〈0．05或P〈0．01）。结论泰嘉与阿司匹林联合使用不仅安全，而且能提高慢性稳定型心绞痛AR患者的临床疗效。     

应用光-化学法血栓生成模型研究急慢性疗法下阿司匹林的抗血栓作用

采用光—化学法在大鼠肠系膜微静脉建立活体血栓生成模型，研究了在急性（一次用药）与慢性（每日给药，一周）条件下阿司匹林的抗血栓作用。慢性阿司匹林用药组与生理盐水对照组相比，可以明显减缓血栓生长速度，延长血栓栓塞时间，表明阿司匹林对血栓形成有一定的抑制作用。而急性用药组的抗栓作用并不明显