摘要
目的应用血栓弹力图(TEG)评价非体外循环下冠状动脉旁路移植(OPCAB)术后早期(14 d内)100 mg/d和200 mg/d阿司匹林治疗下血小板聚集抑制率(INHAA)及获得性阿司匹林抵抗(AR)的发生率,探讨增加阿司匹林剂量对术后早期获得性AR的影响。方法前瞻性连续选取行OPCAB术的患者60例,按术后服用阿司匹林剂量的不同随机分为两组:阿司匹林200 mg组、阿司匹林100 mg组,分别于停药前(Ta)、手术前(Tb)、术后应用阿司匹林治疗后6 h(T1)、第5天(T2)、第14天(T3)进行TEG血小板功能检测。结果术后T1、T2时200 mg组INHAA显著高于100 mg组(P<0.05),T3时两组差异不显著(P>0.05)。T1时AR发生率200 mg组显著低于100 mg组(P<0.05),T2、T3时AR发生率两组差异不显著(P>0.05)。结论 OPCAB术后早期(14 d内)200 mg/d阿司匹林抗血小板治疗可以增加INHAA,减少获得性AR的发生率,有益于术后早期抗血小板治疗。
Objective To compare the AA-induced inhibition rate （ INHAA） of platelet and incidences of aspirin resistance of patients undergoing OPCAB surgery who are receiving two different doses of aspirin （200 mg/d vs.100 mg/d）within the early postoperative period （14 days）,explore the impact of additional dose of aspirin on aspirin resistance .Methods 60 patients underwent OPCAB surgery were randomly divided into two groups （ The 100 mg-group and the 200 mg-group） according to their aspirin dosages of postoperative antiplatelet therapy .INHAA were measured and calculated by thrombelastography （ TEG ） at different time points：Ta （ the day before aspirin was withdrew）,Tb（pre-operation）,T1（6 hours after first application of aspirin after OPCAB）,T2（the 5th day of aspirin therapy）,T3（the 14th day of aspirin therapy）.Results INHAA was significantly increased in patients in 200 mg-group than those in 100 mg-group at T1 and T2（P＆lt;0.05）,INHAA at T3 was not significantly different between the two groups （ P＆gt;0.05 ） .Incidence of AR was significantly reduced in patients in 200 mg-group than those in 100 mg-group at T1.Incidence of AR at T2 and T3 was not significantly different within the two groups （ P ＆gt;0.05 ）. Conclusion Additional dose of aspirin has positive effect on increasing INHAA , reducing the acquired aspirin resistance and improving the efficacy of antiplatelet therapy in early postoperative time （ within 14 days postoperation ） .
出处
《中华临床医师杂志（电子版）》
CAS
2013年第13期49-52,共4页
Chinese Journal of Clinicians(Electronic Edition)
