不同ABO血型病人服用阿司匹林的效果研究及环氧化酶1基因多态性观察

COMPARISON OF ANTIPLATELET EFFECTS AND CYCLOOXYGENASE 1 GENE POLYMORPHISM AFTER ORAL ASPIRIN IN PATIENTS WITH ABO BLOOD GROUP

目的:比较ABO血型病人口服阿司匹林后,血小板功能指标变化情况,探讨阿司匹林的抗血小板作用,以及阿司匹林抵抗相关的环氧化酶-1(cyclo-oxygen-ase-1,COX-1)基因位点rs1330344的基因型在ABO血型间是否存在差异。方法:80例心肌缺血并颈部动脉粥样硬化需口服阿司匹林病人,根据ABO血型分为4组(n=20),分别为A血型组(A组),B血型组(B组),O血型组(O组)和AB血型组(AB组)。比较病人口服阿司匹林前(T1)以及服药1wk后(T2)血小板计数(PLT)、血小板平均体积(MPV)及血栓弹力图最大血块强度(TEGMA)的变化。采用PCR法测定COX-1基因位点rs1330344基因型。结果:T2与T1比较,O组PLT、MPV、TEGMA均减小(p<0.05);AB组TEG-MA增大(p<0.05)。与A组及O组比较,AB组TEG-MA服药前后差值降低(p<0.05)。ABO血型COX-1基因位点rs1330344基因型的比较结果显示,差异均不具有统计学意义(p>0.05)。结论:ABO血型病人服用阿司匹林后抗血小板作用存在差异,其抗血小板作用在O血型病人最显著,在AB血型病人中最差。且其抗血小板差异可能与COX-1基因位点rs1330344无关。

Objective ： To compare the change of platelet function index in ABO blood group pa-tients treated with aspirin, explore the different antiplatelet effects of aspirin in ABO blood groups and the difference of the genotype of rs l330344 in cyclo-o xygen-ase-1 （cox-1） associated with aspirin re-sistance among ABO blood groups.IMetllods ： 80 patients with myocardial ischemia and carotid athero-sclerosis, needed oral aspirin, according to the ABO blood group, were divided into 4 groups （n = 20）：A blood group （ A group） , B blood group （group B） , O blood group （O group） and AB blood group （group AB） respectively. Platelet function indexes including PLT, MPV and TEG-MA were monitored and compared before （T1） and after oral aspirin for a week （T2） . The genotype of rs l330344 in cox- 1 was detected by PCR. Results ： Compared T2 with T1, we found obvious decreases in PLT, MPVand TEG-MA in 0 group（P〈0.05）. Patients in AB group exhibited highest TEG-MA before and after taking medicine （P〈0.05）. All the COX-1 genotype of rs l330344 exhibited no differences （P〉0.05）. Conclusion;The antiplatelet effects are different in ABO blood group patients after taking aspirin,which shows the significant effects in patients with 0 blood group and the weakest effects in patientswith AB blood group. And the difference in antiplatelet effects may be independent of cox-1 gene loceus rsl330344.