不同剂量阿司匹林对冠心病患者胃黏膜损伤的临床研究

目的了解不同剂量阿司匹林对冠心病患者胃黏膜的损伤。方法对每日服用肠溶阿司匹林５０ｍｇ（２６例）、１５０ｍｇ（３０例）和３００ｍｇ（３０例）冠心病患者，观察了服药前和服药７天后临床症状、大便潜血试验、胃镜下胃黏膜表现及胃黏膜病理学变化，采用放免法测定了胃液前列腺素Ｅ２（ＰＧＥ２）和血浆血栓素Ｂ２（ＴＸＢ２）水平。结果阿司匹林每日３００ｍｇ剂量组治疗后，胃镜下胃黏膜病变程度及胃黏膜病理学指标均显著高于另两组（Ｐ值均＜０．０１），而胃液ＰＧＥ２水平较另两组显著降低（Ｐ值均＜０．００１），另两组之间差异无显著性。结论冠心病患者每日服用阿司匹林１５０ｍｇ既能显著降低血浆ＴＸＢ２水平，对胃黏膜近期又无明显损伤。

Lesions of gastric mucosa caused by different low doses of aspirin in patients with coronary heart disease

Objective To investigate the lesions of gastric mucosa caused by different low doses of aspirin in patients with coronary heart disease. Methods Three groups of patients were orally given aspirin 50 mg ( n =26), 150 mg ( n =30) and 300 mg ( n =30) respectively. The clinical symptoms were observed. Stools for occult blood gastroscopy and gastric mucosal histologic examination were carried out. The levels of prostaglandin E 2(PGE 2) in gastric juice and throbomxane B 2(TXB 2) in plasma were measured with radioimmunoassay before and 7 days after treatment. Results The degree of gastric mucosal lesion endoscopically and the histopathologic index were significantly higher in the group with 300 mg of aspirin than those in the other two groups ( P <0.01, both). While the PGE 2 level in gastric juice was markedly lower in group with 300 mg of aspirin than that in the other two groups ( P <0.001, both). There was no difference of the indices mentioned above in the other two groups. Conclusion It is demonstrated that 150 mg of aspirin orally given daily to patients with coronary heart disease can markedly reduce plasma TXB 2 level but does not cause marked damage to gastric mucosa in the near future.