评估阿司匹林对血小板功能的剂量相关影响:来自阿司匹林诱导血小板效应 (ASPECT) 研究的结果
Paul A Gurbel1, Kevin P Bliden, Joseph DiChiara
1Sinai Center for Thrombosis Research, Hoffberger Bldg, Suite 56, 2401 W. Belvedere Ave, Baltimore, MD 21215, USA. pgurbel@lifebridgehealth.org
Circulation
|June 15, 2007
概括
在冠状动脉疾病患者中,阿司匹林在所有剂量中都有效抑制血小板功能. 然而,阿司匹林耐药性因试验而异,这表明潜在的非环氧化原酶-1通路.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
- 血液学 血液学 血液学
背景情况:
- 阿司匹林的抗血小板作用是通过循环氧化酶-1抑制.
- 在冠状动脉疾病 (CAD) 中,阿司匹林耐药性的患病率受到争议.
- 阿司匹林剂量对血小板抑制的影响需要澄清.
研究的目的:
- 用各种测定方法评估CAD患者对阿司匹林的反应能力.
- 调查阿司匹林剂量与血小板抑制之间的关系.
主要方法:
- 对125名稳定的CAD门诊患者进行前性,双盲,双交叉研究.
- 患者接受阿司匹林剂量为每天81毫克,162毫克和325毫克,分别为4周.
- 血小板功能通过阿拉基酸 (AA) 诱导的光传导度聚合,瘤造影,VerifyNow,原/ADP诱导的聚合,PFA-100和尿中的11-脱甲 B2.2来评估.
主要成果:
- 阿司匹林在所有剂量中都显示出低血小板功能,特别是在AA诱导的聚合时.
- 阿司匹林耐药性范围从0-6% (AA激动剂) 到1-27% (其他方法).
- 血小板反应显示了对原/ADP聚合,PFA-100和尿中的11-脱水甲酸B2的剂量依赖性.
结论:
- 评估阿司匹林耐药性高度依赖于试验.
- 阿司匹林在所有测试剂量中有效抑制AA诱导的血小板功能.
- 剂量依赖的效应表明潜在的非环氧化原酶-1抗血小板机制需要进一步研究.
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