摘要
目的探讨冠心病患者长期使用阿司匹林治疗是否存在药物抵抗。方法对100例冠心病患者进行一项超过5年的前瞻性随机临床试验,在这5年内,对试验患者进行了持续跟踪检测。同样,我们也调查研究了长期使用阿司匹林50～100mg是否会对血小板反应产生影响,并记录了发生的心血管病症,同时分别评估了血小板对阿司匹林,前列腺素和二磷酸腺苷,胶原蛋白,肾上腺素引发的血小板聚集敏感性。此外,还测量了血小板球蛋白和炎症指标。结果 4例失访,10例死亡,11例发生了非致死性心血管事件。在两组中,对阿司匹林的血小板反应和引用变量在超过5年内都保持不变。对于被发现患有心血管症状的患者,其在最后的检测阶段中并未对阿司匹林产生异样的血小板反应。然而,相对于无心血管症状且不受50或100mg阿司匹林摄入量影响的患者,有非致命性和致命性心血管症状的患者则显示出了更高的炎症指标。结论总之,我们的研究表明,对于使用50和100mg阿司匹林或者患心血管病超过5年的冠心病患者来说,抗血小板反应没有发生差异。
Objective To explore whether the patients with Coronary Heart Disease will develope decreased sensitivity to aspirin during long-term therapy. Methods A prospective randomized clinical trial with serial monitoring over 5 years was conducted in 100 patients with documented coronary heart disease. We investigated whether long-term treatment with aspirin 50 and 100 mg affects platelet response similarly. Occurrence of CV events was documented. Platelet sensitivity to aspirin, prostacyelin, and adenosine diphosphate-, collagen-, and epinephrine-induced platelet aggregation were evaluated over time. In addition, thromhoglobulin and inflammatory markers were measured. Results Four patients were lost to follow-up and 10 patients died. Eleven patients developed nonfatal CV events. In the 2 groups platelet response to aspirin and the referenced variables remained unchanged over 5 years. In patients who developed CV events, the last monitoring interval revealed no difference in platelet response to aspirin. However, patients with nonfatal and fatal CV events showed increased inflammatory markers versus patients without CV events independent of aspirin 50 or 100 mg intake. Conclusion our study revealed no difference in antiplatelet response to aspirin 50 versus 100 mg or CV events over 5 years in patients with coronary heart disease.
出处
《心血管病防治知识（学术版）》
2012年第3期23-25,共3页
Prevention and Treatment of Cardiovascular Disease
