摘要
目的探讨不同阿司匹林抵抗类型原发性高血压患者服用阿司匹林后血小板聚集率(PAG)及血、尿血栓素B2(TXB2)的变化及临床意义。方法将101例原发性高血压患者根据阿司匹林抵抗的不同分为阿司匹林抵抗(AR)组9例,阿司匹林半抵抗(ASR)组23例,阿司匹林敏感(AS)组69例。分别测定各组患者服用阿司匹林前及服用阿司匹林1周(服用剂量为100mg/d)后PAG及血、尿TXB2浓度,并进行对比分析。结果用药前3组间各检测指标的差异均无统计学意义(均P>0.05),服用阿司匹林1周后,3组患者各检测指标均显著低于用药前(均P<0.01);与AS组用药后比较,ASR组各指标并无明显差异(均P>0.05),而AR组各检测指标均显著高于AS组(均P<0.01);与ASR组用药后比较,AS组各指标并无明显变化(均P>0.05),AR组血TXB2及尿TXB2浓度均显著高于ASR组,但PAGAA及PAGADP并无明显变化(均P>0.05)。此外,血浆TXB2浓度与PAGADP呈现显著的正相关(P<0.01),与PAGAA亦表现出明显的相关性(P<0.05);但尿TXB2浓度与PAGADP及PAGAA均未表现出明显的相关性(均P>0.05)。结论阿司匹林可降低原发性高血压患者的PAG和TXB2,有可能在一定程度上降低原发性高血压患者血栓形成的危险;原发性高血压患者血TXB2浓度与AR有一定相关性,亦可作为类似于PAG的另一种生化检测指标,对指导临床治疗,尤其是指导制定AR患者用药方案提供了较为重要的参考。
Objective To investigate the changes of platelet aggregation （PAG） and thromboxane B2 （TXB2） in blood and urine in patients of essential hypertension （EH） with different status of aspirin resistance and its significance. Methods One hundred and one EH patients were classified as aspirin resistance （AR group, n=9）, aspirin semi-resistance （ASR group, n=23） and aspirin sensitive （AS group, n=69）. PAG and TXB2 in blood and urine were measured before and one week after aspirin was taken （100mg/d）. The correlation between PAG and TXB2 was analyzed. Results Before aspirin taking there were no statistical differences in AA and ADP -induced PAG and plasma and urinary levels of TXB2 among three groups （P〉0.05）. One week after aspirin was taken, PAG and TXB2 levels in all three groups were lower than those before aspirin taking （P〈0.01）. There were no statistical differences in PAG and TXB21evels after aspirin taking between ASR and AS groups （P〉0.05）, while the above parameters in AR group were higher than those in AS group （P〈0.01）. There were no statistical differences in PAG and TXB2 between AS and ASR after aspirin was taken （P〉0.05）, while those parameters in AR group were higher than those in ASR group. There were no statistical differences between AR and ASR in AA and ADP-induced PAG （P〉0.05）. Plasma TXB2 levels were positively correlated with PAG induced-ADP （P〈0.01）; however, there was no correlation between levels of urinary TXB2 and PAG （P〉0.05）. Conclusion Aspirin may decrease platelet aggregation and levels of thromboxane B2 and further lower the thrombogenic risk in EH patients.
出处
《浙江医学》
CAS
2008年第6期545-547,共3页
Zhejiang Medical Journal
基金
温州市科技局科研项目(Y20070167)
