阿司匹林抵抗与血清血栓素B_2的相关性研究

Correlation of aspirin resistance and serum thromboxane B_2

目的调查动脉粥样硬化高危人群中发生阿司匹林抵抗的流行病学特征以及与血清血栓素B2(TXB2)水平变化之间的关系。方法筛选200例动脉粥样硬化高危患者,服用阿司匹林(100mg/d)7d以后,用二磷腺苷(ADP)和花生四烯酸(AA)作诱导剂测定血小板聚集功能,并测定其前后血清TXB2的含量。结果阿司匹林完全抵抗(AR)者为4.5%,阿司匹林半抵抗(ASR)者为20.5%,阿司匹林敏感(AS)者为75%。在AR或者ASR患者中女性和吸烟者占的比率较AS者高(P<0.005)。动脉粥样硬化高危人群的血清TXB2平均水平显著高于健康人群对照组(P<0.01);AR、ASR组血清TXB2含量高于AS组并有极显著差异(P<0.01)。结论血清TXB2水平同阿司匹林抵抗性密切相关。预测AR、血清TXB2水平有助于动脉粥样硬化高危人群个体化抗血栓治疗方案的制定。

Objective To explore the mechanisms of aspirin resistance in the patients with high risk factors of atherosclerosis, and analyze its relationship with serum TXB2 level. Methods Two hundred patients took aspirin（ 100mg/d） for more than 7 days. Platelet aggregation function using adenosine diphosphate（ADP） and arachidonic acid（AA）, were detected Cerum TXB2 levels. Results 4.5 % of the patients showed aspirin resistant （AR）, 20.5 % were aspirin semi-responders （ASR）, and 75 % were aspirin-sensitive（AS）. Patients in AR or ASR group were more likely to be women or current smokers. Serum TXB2 levels of cases with high risk of atherosclerosis were higher than that of control group（P〈0.01 ）. Serum TXB2 levels of cases who are AR or ASR were also significantly higher than that of aspirin-sensitlve cases（ P 〈 0.01）. Conclusion Serum TXB2 level has obvious relationship with the aspirin effect. Aspirin resistance may contribute to the occurrence of cardiovascular events in the patients with high risk factors of atherosclerosis.