脑心通对阿司匹林抗血小板治疗的干预作用

作者	单位
陈达开	温州医学院附属第一医院心内科
张怀勤	温州医学院附属第一医院心内科
张建华	温州市第三人民医院心内科

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中文摘要:

目的探讨小剂量阿司匹林对心脑血管疾病患者血小板生化指标的影响及脑心通的干预作用。方法145例心脑血管疾病（糖尿病、高血压病、冠心病和脑梗死）患者服用阿司匹林1周后,检测用花生四烯酸（AA）和二磷酸腺苷（ADP）作诱导剂的血小板聚集率（PAG）、血浆P-选择素和血栓素B₂（TXB₂）浓度;然后随机分为阿司匹林组和脑心通组,均继续口服阿司匹林,脑心通组加用脑心通胶囊;治疗1个月后复查PAG、血浆P-选择素及TXB₂浓度。结果第1次检测:血浆P-选择素、TXB₂浓度与AA诱导的PAG均呈正相关（r=0.449,r=0.576,P<0.01）,与ADP诱导的PAG均呈正相关（r=0.525,r=0.501,P<0.01）;血浆P-选择素浓度与TXB₂浓度呈正相关（r=0.610,P<0.01）;两组间比较3项指标差异无统计学意义（P>0.05）。第2次检测:两组AA和ADP诱导的PAG、血浆P-选择素和TXB₂浓度均显著低于第1次检测值（P<0.01）;脑心通组上述指标均显著低于阿司匹林组（P<0.05）;两组不良反应发生率差异无统计学意义（P>0.05）。结论心脑血管疾病患者服用阿司匹林1周时抗血小板疗效尚不理想,加用脑心通能提高其抗血小板疗效,且不增加不良反应。

英文摘要:

Objective To investigate the effect of small dosage aspirin on platelet biochemical indexes in pa- tients with cardio-cerebrovascular diseases and the intervening action of Naoxintong （NXT）.Methods The blood levels of P-selectin （P）,thrombin B₂ （TXB₂）,and platelet aggregation （PAG） induced by arachidonic acid （AA） and adenosine diphosphate （ADP） were determined in 145 patients with cardio-cerebrovascular diseases （diabetes mellitus,hypertension,coronary heart disease and cerebral infarction）,after they were medicated with aspirin 100 mg per day for 7 days.Then they were randomly assigned to the aspirin group and the NXT group Both groups took aspirin 100 mg per day continually,but to patients in the NXT group,NXT 9 tablets per day was given addi- tionally.The blood levels of above-mentioned biochemical indexes were re-examined 1 month after medica- tion.Results The first determination showed the plasma level of P-selectin and TXB2 concentration were positively correlated with PAG,either induced by AA （r=0.449,P<0.01 and r=0.576,P<0.01） or by ADP （r= 0.525,P<0.01;r=0.501,P<0.01）.Positive correlation also showed between plasma level of P-selectin and TXB₂ （r=0.610,P<0.01）.There was no significant difference of all the three indexes between the two groups （P>0.05）.Re-examination showed that levels of the 3 indexes significantly decreased in both groups （P<0.01）, and all were lower in the NXT group than in the aspirin group respectively （P<0.05）.There was no significant difference in the incidence of adverse reaction between two groups （P>0.05）.Conclusion The anti-platelet effect of one-week administration of aspirin for patients with cardio-cerebrovascular diseases can not be optimal,the combination with NXT could enhance the effect without increase of adverse reaction.

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