阿司匹林抑制房间隔或室间隔缺损封堵术后血小板聚集

目的 观察房间隔缺损（atrial septal defect，ASD）、室间隔缺损（ventricular septal defect，VSD）介入封堵术前后血小板聚集的变化并探讨封堵术后服用阿司匹林的合适剂量。方法 选择成功进行ASD、VSD介入封堵术的患者各16例．按口服阿司匹林肠溶片的剂量随机分为3mg／kg组和5mg／kg组，分别于术前、术后即刻、术后第4日抽静脉血并测定花生四烯酸（arachidonic acid，AA）、二磷酸腺苷（adenosine diphosphate，ADP）诱导的血小板聚集率。结果 ①ASD、VSD患者介入封堵术后血小板聚集率明显增加（P〈0．01），术后第4日血小板聚集率明显下降（P〈0．01）；②术后口服阿司匹林3mg／kg组与5mg／kg两组患者介入封堵术后第4日血小板聚集率差异无统计学意义（P〉0．05）。结论 ASD或VSD封堵术后即刻血小板聚集明显增加，封堵术后第4日血小板聚集明显减弱，口服3mg／kg的阿司匹林抑制血小板聚集疗效类似5mg／kg。

Influence of aspirin on platelet aggregation in patients after transcatheter closure of atrial or ventricular septal defect

Objectives To observe the state of platelet aggregation in patients before and after transcatheter closure of atrial or ventricular septal defect,and to explore the optimal dosage of aspirin after the device implantation. Methods Thirty-two patients(ASD 16,VSD16)who underwent succcesful transcatheter closure were chosen to two groups which one accepted aspirin 3 mg/kg/d and another accepted 5 mg/kg/d. The platelets aggregation rate before,instantlty and four days after the device implantation induced by AA and ADP were measured. Results 1. There were significant increase of the platelets aggregation rate of all the patients instantly(P<0.01) and decreased four days(P<0.01) after the device implantation. 2. There was no significant defferences of the platelets aggregation rate between the two groups of whom one accepted aspirin 3 mg/kg/day and another 5 mg/kg four days after the device implantation(P>0.05). Conclusions 1. There are significant increase of the platelets aggregation of all the patients instantly and decreased four days after the device implantation. 2. Compared with another group,the platelet aggregation could be inhibited equal effectually by aspirin for 3mg/kg each day.