中低危高血压患者阿司匹林抵抗早期干预治疗的临床研究

目的研究中低危高血压患者阿司匹林抵抗(AR)发生的情况,及早期干预治疗对心脑血管事件发生率的影响。方法对973例诊断为高血压病中低危组患者口服阿司匹林100mg连续14d,进行阿司匹林抵抗检测,选择其中存在阿司匹林抵抗并愿意进入研究的患者183例,随机分为阿司匹林组和干预组,所有患者都规范服用降血压药物及高血压2级预防,阿司匹林组仍然继续服用法阿司匹林100mg、qd,干预组改用氯吡格雷75mg、qd,6个月后检测血小板聚集率(MAR),随访患者2年,比较2组发心脑血管事件发生率。结果 973例患者中存在阿司匹林抵抗者247,发生率为25.3%,治疗6个月后干预组血小板聚集率(MAR)下降较阿司匹林组明显(P<0.05),2年内心脑血管事件发生率干预组低于阿司匹林组(P<0.05)。结论阿司匹林抵抗在高血压患者中确实存在,其发生率与其他心脑血管疾病患者基本类似,及时换用安全有效的抗血小板制剂氯吡格雷,可降低血小板凝聚力,降低心脑血管事件发生。

The Clinical Research on Early Intervention in Aspirin Resistance Patients with Mild-to-moderate Hypertension

Objective To investigate the effect on the incidence of cardio-cerebrovascular event after early intervention therapy. Methods 183 volunteers with aspirin resistance were categorized randomly into aspirin group and intervention group. All patients took antihypertensive drugs regularly and received secondly prevention of hypertension. Aspirin group took aspirin （100mg/d） continuously, while the intervention group changed into clopidogrel （75mg/d）. Platelet maximum aggregation rate （MAR） was measured after 6 months. The incidence of cardio-cerebrovascular event was compared between two groups. Result MAR in intervention group decreased much more than in aspirin group after 6 months （P〈0.05）. Incidence of cardio-cerebrovascular event in intervention group was lower than aspirin group among 2 years （P〈0.05）. Conclusion It proves to be safe and effective to change aspirin into clopidogrel. It can reduce platelet aggregation and prevent cardio-cerebrovascular event.