阿司匹林能降低血液透析患者血清C反应蛋白水平

目的 评价阿司匹林对血液透析患者高敏C反应蛋白(hsCRP)的影响及预防血透患者动静脉内瘘栓塞的有效性和安全性。 方法 采用前瞻性随机对照研究设计。纳入采用自身动静脉内瘘血管通路进行透析≥3个月的维持性血液透析患者110例，按随机数字表法分为干预组（55例）和对照组（55例），并进一步根据年龄分为≤60岁和>60岁亚组。干预组服用阿司匹林100 mg/d 6个月，随访两组患者的微炎性反应和凝血指标、内瘘栓塞率以及服药后的不良反应。 结果 干预组年龄≤60岁的患者服药6个月后，血小板聚集率（PAR）和 hsCRP 水平分别为（68.14±8.45）%和（4.79±4.81） mg/L，较服药前（82.37±9.12）%和（6.94±10.26） mg/L显著下降（均P < 0.05），并显著低于对照组PAR（74.7±11.50）%和hsCRP（5.12±9.25） mg/L（均P < 0.05）。研究过程中干预组和对照组各发生2例内瘘栓塞，内瘘栓塞率两组间差异无统计学意义（P = 0.676）。干预组的不良事件发生率高于对照组，但差异无统计学意义（20.0%比7.2%，P = 0.052），两组间的病死率差异无统计学意义（3.6%比0，P = 0.495）。 结论 使用阿司匹林100 mg/d 6个月，可以显著降低年龄≤60岁的血液透析患者的PAR及hsCRP水平，改善微炎性反应状态，不会引起严重不良反应，但是对动静脉内瘘栓塞的预防作用还有待于更长时间、更大样本的研究证实。

Aspirin can reduce serum C reactive protein level in maintenance hemodialysis patients

Objective To identify the efficacy and safety of aspirin in reducing the serum high sensitivity C reactive protein(hsCRP)level and preventing the internal arteriovenous fistulas(AVF)embolism in maintenance hemodialysis patients. Methods One hundred and ten hemodialysis patients using AVF more than 3 months were randomly divided into 2 groups,the intervention group(n=55,received aspirin 100 mg/d)and the control group(n=55).Examinations were performed at baseline and 6-month after treatment.Serum hsCRP level,platelet aggregates ratio(PAR),coagulation and inflammation indicators were measured.AVF embolism and the adverse events were monitored. Results Six months later.PAR and hsCRP level of the intervention group patients aged≤60 years decreased significantly [(68.14±8.45)%vs (82.37±9.12)%;(4.79±4.81)mg/L vs(6.94±10.26)mg/L,all P＜0.05],and were significantly lower as compared to.the control group[(68.14±8.45)%vs(74.7±11.50)%,(4.79±4.81)mg/L vs(5.12±9.25)mg/L,all P＜0.05].There were 2 cases of AVF embolism occured in both groups,which showed no statistical difierence (P=0.676).The incidence of adverse effeets was higher in the intervention group than that in the control group but no statistical significance was found (20.0%vs 7.2%,P=0.052),while the mortality rate had no difference between 2 groups (3.6%vs 0,P=0.495).Conclusion Use of aspirin 100 mg/d for 6 months can significantly reduce the serum hsCRP level and PAR in hemodialysis patients under 60-year-old without serious adverse reactions.