阿斯匹林在早期溶栓治疗急性心肌梗死中的作用

Role of aspirin on early thrombosis in treatment of acute myocardial infarction

目的：探讨阿斯匹林在早期溶栓治疗急性心肌梗死（ＡＭＩ）及预防ＡＭＩ后早期再梗死、梗死延展中的作用。方法：治疗组７２例ＡＭＩ患者急性期应用尿激酶溶栓时首剂顿服阿斯匹林３００ｍｇ，以后每日１００ｍｇ维持。对照组３０例ＡＭＩ患者急性期应用尿激酶溶栓时每日静滴丹参注射液１６ｍｌ，２周后改口服丹参片。观察２组患者早期再梗死、梗死延展、病死率发生情况及血小板计数、血小板凝聚试验和出凝血时间的变化。结果：治疗组血小板计数降低，血小板凝聚试验、出凝血时间延长，与对照组比较均有显著性差异（Ｐ均＜０．０１）；治疗组ＡＭＩ后早期再梗死、梗死延展的发生率较对照组明显减少，心脏性病死率亦明显降低（Ｐ均＜０．０１）。结论：阿斯匹林对血小板聚集和释放、血栓形成有明显抑制作用，提高了溶栓效果，同时减少了ＡＭＩ后早期再梗死及梗死延展的发生率。

Objective:To investigate the effect of aspirin on early thrombosis in treatment of acute myocardial infarction(AMI) and preventing reinfarction during early stage as well as infarction deve lopment .Methods:Seventytwo cases (treatment group) of AMI during acute phase were treated with urokinase for thrombosis and oral aspirin 300 mg at once,then oral aspirin 100 mg daily for maintenance until discharge from hospital;while control group (30 cases) was treated with urokinase and salvia miltiorrhiza injection 16 ml intravenous drip for 2 weeks,then oral salvia miltiorrhiza tablet for maintinance.In addition,to observe the reinfarction during early stage,infarction development and mortality as well as platelet counts,platelet aggregation test and coagulating time.Results:The treatment group was showed the platelet counts were reduced , platelet aggregation test and coagulating time were prolonged;it has obvious difference as compare to control group (all P <0 01).Moreover,the generative rates of early stage reinfarction and infarction development were decreased after AMI in treatment group;the mortality from heart disease was lower obviously (all P <0 01).Conclusions:Aspirin can inhibit the platelet aggregation,prevent thrombosis,enhance the thrombolytic action and decrease the reinfarction rate during early stage and infarction development after AMI.