奥美拉唑对阿司匹林抗血小板作用的影响

The Effect of Omeprazole on Aspirin Anti-platelet Action

背景已有研究表明奥美拉唑可以预防阿司匹林引起的胃黏膜病变,但奥美拉唑是否影响阿司匹林的抗血小板凝集作用,则未见报道。目的通过血小板聚集率的检测探讨奥美拉唑对阿司匹林抗血小板作用的影响。方法入选的90例稳定型心绞痛患者被随机分为两组:对照组单用阿司匹林45例,服用阿司匹林肠溶片100 mg,1次/d;联合组45例,服用同种剂量阿司匹林肠溶片加奥美拉唑肠溶片20 mg,1次/d。两组均在给药前1天、服药后10 d分别测定血小板聚集率。比较两组患者血小板聚集率的差异。结果在两组患者中,年龄、性别、身高、体质量以及心血管疾病的危险因素(高血压、糖尿病、高血脂症等)差异无统计学意义。对照组及联合组治疗后较治疗前以花生四烯酸(ACA)和腺苷二磷酸(ADP)诱导的血小板聚集率均显著降低(P<0.05)。以ACA作诱导剂,联合组治疗后的血小板聚集率为(45.6±3.7)%,对照组为(40.2±3.6)%,差异无统计学意义(P>0.05);以ADP作诱导剂,联合组治疗后的血小板聚集率为(75.0±3.1)%,对照组为(71.6±2.8)%,差异无统计学意义(P>0.05)。结论奥美拉唑对阿司匹林的抗血小板作用无明显影响。

Background A number of research reported the omeprazole protective effect on gastromucosa lesion induced by aspirin, but whether omeprazole might interfer with the antiplatelet-aggregation was uncertain. Objective To explore the effect of omeprazole treatment on aspirin anti-platelet action by examining the platelet aggregation rate. Methods Ninety patients with stable coronary heart disease were randomly to receive aspirin enter- ic-coated tablets 100 mg/d or omeprazole enteric coated tablets 20 mg/d combined with aspirin enteric-coated tablets 100 mg/d （n=45）. The platelet aggregation rate was examined before and 10 days after administration. The differences of the platelet aggregation rate were compared. Results The baseline data of age, sex, body height, body mass and cardiovascular disease risk factors （hypertensive disease, diabetes mellitus, hyperlipidemia, et al） were not significantly different between two groups. After administration with aspirin enteric-coated tablets or omeprazole associated with aspirin, the platelet aggregation rate was reduced significantly （P〈0.05）. The platelet aggregation rate with arachidonic acid （ACA） was （45.6±3.7）% in combined group and （40. 2±3. 6）% in aspirin alone group （ P〉0. 05 ） ; while the rate induced by adenosine diphosphate （ ADP ） was （ 75.0 ± 3.1 ） % in combined group and （71.6±2.8） % in alone group （ P〉0. 05）. Conclusion Omeprazole did not effect the anti-platelet aggregation effect induced by aspirin.