老年心血管疾病中阿司匹林抵抗现象的研究

目的研究不同剂量阿司匹林对阿司匹林抵抗的影响。方法68例本院门诊或住院老年心脑血管疾病患者,随机分为阿司匹林低剂量组(100mg/天)及阿司匹林高剂量组(300mg/天),分别测定阿司匹林治疗前和治疗14天后血小板聚集率和血栓素B2水平。结果不同剂量阿司匹林均能产生有效的抗血小板作用,两组均有阿司匹林抵抗,低剂量组占40%,高剂量组占30.3%。在不稳定性心绞痛和稳定性心绞痛患者之间,阿司匹林抵抗发生率有统计学差异(P<0.01),不稳定性心绞痛患者阿司匹林抵抗发生率较高。结论无论阿司匹林治疗剂量高低,老年心脑血管疾病患者中均有部分患者出现阿司匹林抵抗,不稳定性心绞痛影响较明显。

Aspirin Resistance in the elder Cardio-Cerebral-Vascular Diseases Patients

Objectives We investigated the effect of different-dose aspirin to the cardio-cerebral-vascular diseaes patients with aspirin resistance and analyze the possible effect factors of aspirin resistance.Methods we study 68 elder cardio-cerebral-vascular disease patients between january 2003 and October 2005 who were taking 100mg or 300mg aspirin randomly.Serum thromboxane(TX) B2 level and platelet aggregation were assayed before and after 14days of aspirin.Aspirin resistance was defined as an aggregation of ≥67% with 2.0μmol ADP or ≥70% with 5.56mmol adrenaline or serum TXB2≥87.25pg/ml.Results different-dose aspirin can inhibit platelet aggregation and decrease serum TXB2 level(P<0.05～P<0.01).But some elder patients present aspirin resistance in both low dose and high-dose group,the prevalence of aspirin resistance was 40% and 30.3% respectively.We compared the prevalence of aspirin resistance between stable angina and unstable angina.The difference was statistically significant(P<0.01) between two groups,the prevalence of unstable angina was higher. Conclusions There are aspirin resistance phenomena in some elder cardio-cerebral-vascular diseases patients despite aspirin dosage.Unstable angina maybe the affect factor in aspirin resistance.