稳定型心绞痛患者对阿司匹林的反应性

目的: 探讨在冠心病患者中，阿司匹林的个体差异及相关因素。方法: 稳定型心绞痛患者100例，服拜阿司匹林100 mg/d，7 d后测定血栓素B2（TXB2）、6-酮-前列腺素F1α（6-keto-PGF1α）、D-二聚体（D-D）、纤维蛋白原（FIB）、同型半胱氨酸（HCY）及C反应蛋白（CRP）水平，同时使用血栓弹力仪测定血小板的反应性，并根据反应性不同将患者分为四分位组（高反应性组和低反应性组），观察两组患者的临床特征。结果: 血小板反应性呈正态分布；高反应性的患者中女性（52% vs.28%，P<0.05）及糖尿病患者（64% vs.32%，P<0.05）的比例较高；血栓前状态标记物中TXB2［(102±17)ng/L vs.(74±17)ng/L,P<0.05］及CRP［(7.7±1.6)mg/L vs.(4.3±1.2)mg/L,P<0.05］在血小板高反应性的患者中高于低反应性组。结论: 冠心病患者血小板反应性存在个体差异。

Clinical study on platelet reactivity in patients with stable angina

AIM: To investigate the platelet reactivity in patients with coronary heart disease (CHD). METHODS: One hundred stable angina patients were given aspirin (100 mg, once daily) for 7 days. Thromboxane B2 (TXB2), 6-keto-prostaglandin F1α (6-6-keto-PGF1α), D-dimer (D-D), fibrinogen (FIB), homocysteine (HCY), and C-reactive protein (CRP) levels were then measured. The platelet reaction was measured by thrombelastograph (TEG). Patients were divided into high-platelet reaction groups (HPR) and low-platelet reaction groups (LPR). RESULTS: Platelet reactions were normally distributed. Females and patients with diabetes had higher platelet reactivity compared with males (52% vs. 28%, P<0.05) and patients without diabetes (64% vs. 32%, P<0.05). The prothrombotic status marker TXB2 ［(102±17) ng/L vs.(74±17) ng/L, P<0.05］ and CRP ［(7.7±1.6) mg/L vs.(4.3±1.2) mg/L, P<0.05］ were higher in HPR patients. CONCLUSION: Platelet reactivity in CHD patients has demonstrated some individual differences.