不同剂量阿司匹林对冠心病患者血小板活性和数目的影响

EFFECTSOFDIFFERENTLOWDOSESOFASPIRINONPLATELETACTIVATIONANDTHENUMBEROFPLATELETSINTHEPATIENTSWITHCORONARYHEARTDISEASE

为探讨阿司匹林对冠心病患者合适的治疗剂量，采用抗人血活性血小板α颗粒膜蛋白１４０（ＧＭＰ－１４０）特异单克隆抗体１２５Ｉ－ＳＺ－５１测定不稳定心绞痛患者，每日服用阿司匹林５０ｍｇ（２７例）、１５０ｍｇ（２６例）、３００ｍｇ（３０例）治疗前和治疗７天后三组血小板膜表面ＧＭＰ－１４０分子数，并常规计数血小板数目。结果显示阿司匹林治疗后血小板膜表面ＧＭＰ－１４０分子数明显降低，而血小板数目明显升高，并且随着阿司匹林剂量的增加，两者的变化程度也增大（Ｐ值均＜０．０１），当剂量达３００ｍｇ时，前者低于健康人组（Ｐ＜０．００５），后者已达健康人组水平（Ｐ＞０．０５）。三组阿司匹林剂量的近期副作用差别则无显著性。表明用该药治疗不稳定性心绞痛患者开始采用每日３００ｍｇ的剂量是合理的。

Thenumberofalpha-granulemembraneprotein140(GMP-140)moleculeswasdetectedbyusingspecificmonoclonalantibodies(125I-SZ-51)againstGMP-140inthreegroupsofpatientswithunstableanginatreatedwithasprin50mg(n=27),150mg(n=26)and300mg(n=30)adaybeforeand7daysaftertreatment.Thenumberofplateletswascountedbyusingtheroutinemethod.Theresultsindica-tedthatthenumberofGMP-140moleculesdecreasedsignificantlyandthenumberofplateletsin-creasedsignificantlyaftertreatmentwithaspirin.Withtheincreaseofaspirindosagethedegreeofthesetwochangesincreased(P<0.01,both)too.When300mgofaspirinwasused,thenumberofGMP-140moleculeswaslowerthanthatinacontrolgroupofhealthysubjects(P<0.005)andthenumberofplateletsreachedthatofthecontrolgroup(P>0.05).Therewasnodiferenceontheimmediatesideef-fectswhenthesethreedosagesofaspirinwereused.Theauthorsoftheopinionarethatitisrationaltouse300mgofaspirintotreatpatientswithunstableanginaatthebeginning.