哈尔滨地区心脑血管病患者中阿司匹林抵抗的探讨

Prevalence of aspirin resistance in Harbin patients with cardiovascular and cerebral disease

目的研究哈尔滨地区心脑血管病患者中发生阿司匹林抵抗(AR)概况,并探讨其预测因子。方法110例病情稳定的心脑血管病住院患者,每日服用阿司匹林100mg,连服7天,第8天晨起采取空腹静脉血,分别以二磷酸腺苷(ADP)和花生四烯酸(AA)为诱导剂,检测血小板聚集功能。结果患者中AR发生率为0,阿司匹林半敏感(ASR)者占7.3%,女性较多(男∶女,75.6%与40.5%,P=0.002),吸烟者亦较多(37.5%与17.5%,P=0.001)。结论阿司匹林用于抗血小板治疗及预防动脉粥样硬化事件的心脑血管患者中,若有AR或ASR存在可选用其他安全有效的抗血小板制剂,预测AR及抗血小板治疗个体化,将是抗血小板治疗的发展方向。

Objective To study the prospectively prevalence of aspirin resistance in harbin patients with cardiovascular and cerebral disease and clinical predictors of aspirin resistance.Methods Patients with stable cardiovascular and cerebral disease received 100 mg/d of aspirin dut not other antiplatelet agent for 7 days.Aspirin resistance was analyzed by examination of blood platelet aggregation induced by adenosine diphosphate (AD) and arachidonic (AA).Results There were 7.3% of the patients being aspirin semiresponders.Patients who were aspirin semiresponders were most likely to be women (75.6% vs 40.5%, P =0.002) and more likely to be smokers (37.5% vs 17.5%, P =0.001) as compared with aspirin sensitive (AS) patients.Conclusion The detection of aspirin resistance is particularly important for the large number of patients relying on this medition for antiplatelet therapy and prevention of arterriosclerotic evens.The safe alternative antiplatelet agent for long term administration shoud be used if aspirin resistance appears.The routine identification of patient with aspirin resistance appears to be emerging direction of antiplatelet therapy.