阿司匹林抵抗非瓣膜性房颤的研究.docVIP

阿司匹林抵抗非瓣膜性房颤的研究 　　【摘要】目的：研究非瓣膜性房颤阿司匹林抵抗可能的影响因素及预测指标。方法：既往服用过阿司匹林的非瓣膜性房颤患者共48例，合并脑梗死20例，为阿司匹林抵抗(AR)组，无脑梗死组28例，为阿司匹林敏感(AS)组。通过血小板聚集仪测血小板聚集率，化学免疫法测血清C反应蛋白（CRP），酶法测血脂。结果：二磷酸腺酐(ADP)及肾上腺素(EPI)诱导的最大血小板聚集率[PAG(M)]及1分钟聚集率[PAG(1)]AR组明显高于AS组，ADPPAG(M)60%、EPIPAG(M)60%及两者均60%的比例AR组明显高于AS组，血清总胆固醇(TC)和低密度胆固醇(LDL-C)AR组明显高于AS组。阿司匹林剂量AR组明显低于AS组。血清CRP两组差异无显著性。结论：非瓣膜性房颤（NVAF）患者脑梗死发生与血小板聚集活性增强密切相关，阿司匹林剂量不足可能是产生AR的因素之一。较高水平的血清TC和LDL-C可能是引起AR的因素之一，普通化免法测得的CRP对NVAF出现AR尚无提示作用。 　　【关键词】非瓣膜性房颤；阿司匹林抵抗；血小板聚集；血清C反应蛋白 　　文章编号：1009-5519（2007）24-3637-03 中图分类号：R5 文献标识码：A 　　 　　Study of aspirin resistance in non-valvular atrial fibrillation 　　YANG Hui-jian1，YU Xi-fa2，CHEN Yun-e1 　　(1.The Peoples Hospital of Dongxiang，Jiangxi 331800，China；2.Dongxiang Hospital of Traditional Chinese Medicine，Jiangxi 331800，China) 　　【Abstract】Objective：To study the possible influencing factors of aspirin resistance(AR) in non-valvular atrial fibrillation(NVAF) and its anticipation indices.Methods：20 NVAF patients with cerebral infarction,who had taken long-term aspirin before the occurence of thrombosis were involved as aspirin resistance group(AR group)；28 NVAF patients without cerebral infarction,who had taken long-term aspirin too served as aspirin sensitivity group(AS group).The platelet aggregation rate induced by ADP and EPI was measured by optical platelet agglutometer,while the CRP and blood lipids were measured by common serum chemical immunization and enzymic method respectively.Results:The rates of ADPPAG(M)，ADPPAG(1)，EPIPAG(M) and EPIPAG(1) in AR group were higher than those in AS group.The case proportional number of ADPPAG(M)60%，EPIPAG(M)60% and both of them 60% in AR group was higher than that in AS group.TC and LDL-C in AR group were higher than those in AS group,the aspirin dosage in AR group was lower than that in AS group,there was no significant difference in the serum CRP between two groups.Conclusion：Cerebral infarction may be closely correlated with platelet aggregation enhancement in NVAF,t