葛根素对阿司匹林抵抗患者血小板功能影响的临床研究

Clinical study on platelet inhibition functions of Puerarin in patients with aspirin resistance

目的研究葛根素对阿司匹林抵抗患者血小板功能的影响。方法采用单中心双盲、对照临床试验共入选180例冠心病住院患者,以花生四烯酸诱导的血小板聚集率>50%和二磷酸腺苷诱导的血小板聚集率≥70%作为血小板高反应性的标准,将患者随机分成葛根素+氯吡格雷组(葛根素组)和阿司匹林+氯吡格雷组(阿司匹林组),比较第3天和第7天后患者的血小板功能及相关生化指标。结果与阿司匹林组比较,葛根素组在第3天和第7天均可明显改善AA途径诱导的血小板抑制率(P<0.01),在第3天可以更好地抑制ADP途径诱导的血小板聚集(P<0.05);葛根素组同样可以显著降低TXA2代谢相关产物水平(P<0.05)。结论葛根素可以有效改善阿司匹林抵抗患者中的血小板高反应性,有助于达到理想的血小板抑制水平。

Objective To evaluate the effect of Puerarin on plateletinhibition functions in patients with Aspirin resistance.Methods A single-center double-blinded controlled clinical trial was designed in which totally 180 patients were enrolled with high platelet response（AA-induced aggregation50% and ADP-induced aggregation≥70% with TEG protocol）.All patients were divided into two groups including Puerarin＋Clopidogrel group（Puerarin group） and Aspirin＋Clopidogrel group（Aspirin group）.The platelet aggregation functions,as well as relative TXA2 metabolic product biomarker were measured in indicated time.Results On 3rd and 7th day,AA-induced platelet inhibition percentage can be significantly improved in Puerarin group than that in Aspirin group（P 0.01）.Puerarin group could also obtain better ADP-induced platelet inhibition percentage than Aspirin group（P 0.05） on 3rd day.As to TXA2 metabolite,urinary 11-DH-TXB2 could be significantly reduced in PC group compared with Aspirin group both on 3rd and 7th day（P 0.05）.Conclusion Puerarin can effectively improve high platelet response in patients with Aspirin resistance,and thus help reach an ideal level for platelet inhibition.