低剂量阿司匹林和冠状动脉血管扩张剂在急性不稳定性心痛中的比较
M Vejar1, D Hackett, C Brunelli
1Cardiovascular Research Unit Royal Postgraduate Medical School, Hammersmith Hospital, London, UK.
Circulation
|January 1, 1990
概括
单独的阿司匹林并没有证明在不稳定的胸痛患者中优于血管扩张剂. 一些患者需要积极的治疗,包括早期冠状动脉血管造影,如果初始疗法无法预防心肌缺血或心脏病发作.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学 是一个学科.
背景情况:
- 不稳定性心痛的特点是偶尔的血小板激活.
- 阿司匹林是治疗不稳定性胸痛的关键治疗剂.
研究的目的:
- 在41名不稳定的心痛患者中,评估单独使用阿司匹林与与血管扩张剂 (肝素,β-阻断剂) 结合使用阿司匹林的疗效.
- 为了确定初始治疗是否可以预防心肌缺血的复发.
主要方法:
- 患者被随机分为两组:第一组接受了血管扩张剂 (二二酸盐,二亚),第二组接受了阿司匹林.
- 如果心肌缺血复发,则连续添加治疗 (阿司匹林,血管扩张剂,肝素,β-阻塞剂).
- 测量血清血红素B2水平以评估阿司匹林的有效性.
主要成果:
- 阿司匹林显著降低了血清血红素B2到无法检测的水平.
- 单独的阿司匹林在预防缺血发作方面并不优于冠状动脉扩张剂.
- 30%的患者即使服用肝素和β-阻断剂,也继续出现缺血或心肌梗塞.
- 在不同治疗臂的3名患者中发生心肌梗塞.
结论:
- 冠状动脉栓塞和血管收缩的刺激可能很强,有时会压倒标准对抗药物.
- 早期冠状动脉动脉扫描和积极的治疗是建议的,对于那些没有迅速响应联合治疗的患者.
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