不同阿司匹林抵抗类型的超早期脑梗死患者血栓素B_2与6-酮-前列腺素检测及其意义

目的 探讨不同阿司匹林抵抗类型的超早期脑梗死患者服用阿司匹林后血栓索B_2(TXB_2)与6-酮-前列腺素(6-k-PG)F1 α水平的变化及临床意义.方法 将63例超早期脑梗死患者根据阿司匹林抵抗类型分为阿司匹林抵抗(AR)组、阿司匹林半抵抗(ASR)组和阿司匹林敏感(AS)组,分别测定三组患者服用阿司匹林(100 mg/d)前及2周后TXB_2及6-k-PGF1α水平及两者比值,并进行对比分析及预后评估.结果 AS组总有效率87.0%(20/23)]显著高于ASR组55.0%(11/20)]和AR组30.0%(6/20)],差异有统计学意义(P<0.05);AS组TXB_2和6-k-PGF1α比值增高的患者比例较低.用药前三组患者TXB_2、6-k-PGF1α水平比较差异无统计学意义.用药2周后,三组患者TXB2水平较用药前均显著下降,6-k-PGF1α水平较用药前均显著上升(P<0.01),而且AR组下降或上升幅度小于AS组和ASR组(P<0.01).结论 阿司匹林可降低超早期脑梗死患者的TXB_2水平,并提高6-k-PGF1α水平,有可能在一定程度上降低其再次血栓形成的危险,同时监测TXB_2和6-k-PGF1α比值有助于评估预后.

Effects and significance of thromboxane-B_2 and six-ketone-prostaglandin leveb in primary type hyper-acute cerebral infarction patients with different sensitivities to aspirin

Objective To study the effects and significance of thrombexane -B_2(TXB_2)and six-ketone-prostaglandin(6-k-PG)F1 α levels in the primary type of hyper-acute cerebral infarction with different sensitivities to aspirin.Methods Sixty-three patients with primary type of hyper-acute cerebral infarction were divided into three groups based on their sensitivities to aspirin:aspirin resistance(AR)group,aspirin semiresistance(ASR)group,aspirin sensitivity(AS)group.TXB_2 and 6-k-PGF1α levels were measured,compared and analyzed in the three groups before and two weeks after taking aspirin(100 mg/d).Results The total effective rate in AS group87.0%(20/23)]was significantly higher than that in ASR group55.0%(11/20)]and AR group30.0%(6/20)](P<0.05).There was no significant difference of TXB_2 and 6-k-PGF1 α among the three groups before taking aspirin.After taking aspirin for two weeks,TXB_2 leveh in all the three groups were lower than those before making aspirin(P<0.01),6-k-PGF1α levels in all the three groups were higher than those before taking aspirin(P<0.01).Conclusions Aspirin can decrease the TXB_2 concentration and increase the 6-k-PGF1α concentration of the primary hyper-acute cerebral infarction. It may be reduce the risks of re-infarction after the primary acute infarction. Monitoring the concentration of TXB_2 and 6-k-PGF1α can be helpful to evaluate rehabilitation prognosis.