阿司匹林对慢性心力衰竭患者凝血状态的干预作用  

Interventional effect of aspirin on the coagulative state in patients with chronic heart failure

作　　者：周碧蓉[1] 徐岩[1] 吴继雄[1] 徐元宏[2] 

机构地区：[1]安徽医科大学第一附属医院心内科,安徽省合肥市230022 [2]安徽医科大学第一附属医院检验科,安徽省合肥市230022

出　　处：《中国临床康复》2006年第12期1-3,共3页Chinese Journal of Clinical Rehabilitation

基　　金：安徽省教育厅自然科学基金资助项目(2005KJ352ZC)~~

摘　　要：目的:了解慢性心力衰竭患者体内凝血状态的变化,并观察短期使用小剂量阿司匹林对其凝血状态的干预作用。方法:选择2004-01/2005-07安徽医科大学第一附属医院收治的60例慢性心力衰竭患者(心功能Ⅱ～Ⅳ级),随机分为标准抗心力衰竭组30例及阿司匹林组30例。标准抗心力衰竭组接受标准抗心衰治疗,包括血管紧张素转化酶抑制剂单用或加用利尿剂,合用地高辛0.125～0.25mg/d,心功能Ⅱ～Ⅲ级患者加用β-受体阻滞剂;阿司匹林组在标准抗心衰治疗基础上,加阿司匹林75～100mg/d。在进入试验第1天和治疗2周后采集血标本,分别测定血浆P-选择素、血浆血管性假性血友病因子、D-二聚体水平。以30例同期健康体检者为正常对照组。结果:90例受试者全部进入结果分析。①慢性心力衰竭患者血P-选择素、血管性假性血友病因子和D-二聚体水平明显高于正常对照组眼(21.17±4.05),(16.78±3.26)g/L;(175.63±28.16)%,(125.78±24.95)%;(0.86±0.24),(0.51±0.15)mg/L,P均<0.05演。②标准抗心力衰竭组治疗后P-选择素、血管性假性血友病因子和D-二聚体水平较治疗前均下降眼(18.02±2.65),(21.45±3.97)g/L;(156.23±20.13)%,(175.23±25.6)%;(0.62±0.19),(0.87±0.21)mg/L;P均<0.05演。③阿司匹林组治疗后P-选择素、血管性假性血友病因子和D-二聚体水平较治疗前也显著下降眼(16.39±3.05),(20.87±4.06)g/L;(149.21±23.56)%,(176.01±28.12)%;(0.56±0.20)mg/L,(0.84±0.19)mg/L;P均<0.05演。④标准抗心力衰竭组和阿司匹林组患者治疗前血P-选择素、血管性假性血友病因子和D-二聚体水平差异无显著性(P>0.05);治疗后阿司匹林组组各指标均低于标准抗心力衰竭组,但无统计学意义(P>0.05)。结论:慢性心力衰竭患者体内存在高凝状态,有血栓形成的倾向,短期使用小剂量阿司匹林对心衰的凝血状态影响小,慢性心力衰竭患者阿司匹林使用的剂量及疗程有待于进一步研究AIM： To investigate the changes of the eoagulative state in patients with chronic heart failure （CHF）, and observe the interventional effect of smalldose aspirin on coagulative state, METHODS： A total of 60 patients with CHF （cardiac function of Ⅱ -Ⅳ grade）, who were treated at the First Affiliated Hospital of Anhui Medical University from January 2004 to July 2005, were selected and randomly assigned into standard anti-CHF group with 30 cases and aspirin group with 30 cases. Standard anti-CHF therapy was performed in the standard anti-CHF group, including single angiotensin-eonverting enzyme inhibitor agent or adding diuretic, combing eedoxin 0.125-0.25 mg per day, adding beta-receptor blocker in patients with Ⅱ-Ⅲ cardiac function. Based on the standard anti-CHF therapy, the patients in the aspirin group were also treated with aspirin 75-100 mg per day. Blood sample was collected at the 1^st day entering trial and 2^rd week after treatment, and then plasma P-selectin, plasma yon Willebrand＇s disease and D-dimer level were detected, respectively. Thirty healthy testees were enrolled as normal control group in the same period. RESULTS： Totally 90 testees were involved in the result analysis. ①P-selectin, plasma yon Willebrand＇s disease and D-dimer level in the CHF patients were higher significantly than those in the normal control group [（21.17±4.05）, （16.78±3.26）g/L;（175.63±28.16）%, （125.78±24.95）%; （0.86±0.24）, （0.51±0.15） mg/L,P 〈 0.05].②The P-selectin, plasma yon Willebrand＇s disease and D-dimer level decreased in the standard CHF group as compared with that before treatment [（18.02±2.65）,（21.45±3.97） g/L; （ 156.23±20.13）%, （ 175.23±25.6）% ; （0.62±0.19）, （0.87±0.21） mg/L ; P 〈 0.05].③The P-selectin, plasma yon Willebrand＇s disease and D-dimer level decreased obviously in the aspirin treatment group as compared with that before treatment [（16.39±3.05）,（20.87±4.06） g/L;（149.2±23.56）%, （176.01±28.

关 键 词：心力衰竭 阿司匹林 P选择素 

分 类 号：R541.6[医药卫生—心血管疾病]