摘要
目的探讨阿斯匹林常用剂量下，血小板聚集率的变化规律及诱导剂的选择。方法３０名经体检健康的自愿者，随机分为３组。第一组一次服用２００ｍｇ阿斯匹林，第二组初服１００ｍｇ阿斯匹林后每日５０ｍｇ追加量，连服７天。第三组口服５０ｍｇ阿斯匹林。各组分别在不同时间进行采样，样本用花生四烯酸、瑞斯托霉素、胶原、二磷酸腺苷（ＡＤＰ）四种诱导剂进行血小板聚集实验。结果第一组停药第７天，血小板聚集率恢复到服药前水平。花生四烯酸诱导的血小板聚集实验对口服阿斯匹林最为敏感。第二组，血小板聚集率在服药的７天及停药后９天内与用药前差异有非常显著意义（Ｐ＜００１），在第１０天差异有显著意义（Ｐ＜００５），第１１天恢复至服药前水平。以上两组，花生四烯酸诱导的血小板聚集率的变化比其他诱导剂诱导的变化明显。第三组３天内血小板功能仍受明显抑制。结论首服剂量越大，维持服药的时间越长，血小板聚集功能恢复所需时间越长。
Objective Approach of the dynamic changes of platelet aggregation in treatment of aspirin.Methods Three groups (A, B and C) of volunteers were given different dose of aspirin: 200 mg were given only day on A group (n=10); B group (n=10), 100 mg in the first day, then 50 mg/day in 7 days; 50 mg were given only day on C group (n=10). Plateletrich plasma were obtained in planed days: A group, every day for 7 days after oral aspirin treatment; B group, in the 4th and 7th day after oral aspirin treatment, and the 6th, 8th, 10th and 11th day after finishing oral aspirin treatment; C group, in 2h, 24h, 48h, 72h after oral aspirin treatment. Then platelet aggregation induced by ADP, collagen, ristocetin and arachidonic acid were examined.Result A group, platelet aggregation restored in the 7th day after finishing oral aspirin treatment; B group, in the 18th day after finishing oral aspirin treatment; C group, not restored in the 3rd day after finishing oral aspirin treatment yet. In oral aspirin treatment, there were more sensitive change in platelet aggregation induced by arachidonic acid than other inductor.Conclusion That aspirin inhibit platelet aggregation was relation with dose and the duration of oral aspirin therapy. The platelet aggregation induced by arachidonic acid is available for monitoring oral aspirin therapy.
