不规范剂量阿司匹林对心脑血管疾病高危患者的影响

Impact of Non-Standardized Dosage of Aspirin on High Risk Patients with Cardiocerebrovascular Diseases

目的探讨不规范剂量阿司匹林对心脑血管疾病高危患者的影响。方法选择2007年6—12月于我院门诊和社区规律服用阿司匹林40~150 mg/d、满2周以上的患者456例,其中服用阿司匹林≥75 mg/d者定义为规范剂量组275例,〈75 mg/d者定义为不规范剂量组181例,对两组的血小板聚集率及其影响因素进行分析。结果规范剂量组花生四烯酸（AA）和二磷酸腺苷（ADP）诱导的血小板聚集率分别为（11±3）%、（70±11）%,不规范剂量组分别为（22±6）%、（73±9）%,两组患者AA和ADP诱导的血小板聚集率间差异均有统计学意义（P〈0.01）。规范剂量组AA和ADP诱导的血小板聚集异常率分别为12.73%、52.00%,不规范剂量组分别为25.41%、64.64%,两组患者AA和ADP诱导的血小板聚集异常率间差异亦均有统计学意义（P〈0.01）。Logistic分析显示,女性、超重、吸烟是不规范剂量组发生血小板聚集异常的危险因素,吸烟是规范剂量组的危险因素。结论心脑血管疾病高危患者应规范阿司匹林的服用剂量,以达到满意的抑制血小板聚集的结果,从而减少因心脑血管不良事件导致的死亡的发生。

Objective To investigate the impact of non-standardized dosage of aspirin on high risk patients with cardiocerebrovascular diseases.Methods Totally 456 outpatients,who regularly receive asprin 40-150 mg/d,from Beijing Anzhen Hospital and community health service centers from June to December of 2007 were enrolled.Of which 275 patients who received asprin ≥75 mg/d were taken as standard group and 181 patients who received asprin 75 mg/d were taken as non-standard group.The platelet aggregation rate and its influential factors were analyzed.Results The platelet aggregation rates induced by arachidonic acid（AA） and adenosine diphosphate（ADP） were（11±3）%,（70±11）% respectively in standard group;and（22±6）%,（73±9）% respectively in nonstandard group（P0.01）.The abnormal rates of platelet aggregation induced by AA and AD were 12.73%,52.00% respectively in standard group;and 25.41%,64.64% respectively in nonstandard group（P0.01）.Logistic regression analysis showed that,for abnormal platelet aggregation,female,overweight and smoking were independent risk factors in non-standard group,and smoking was independent risk factor in standard group.Conclusion The high risk patients with cardiocerebrovascular diseases should taken aspirin of standardized dosage to inhibit platelet aggregation properly,and thus to reduce death induced by cardiocerebrovascular accidents.