西洛他唑对冠心病患者阿司匹林抵抗的干预作用  

Interference of Cilostazol to Aspirin Resistance in Patients with Coronary Heart Disease

作　　者：梁海峰[1] 刘新华 

机构地区：[1]河北北方学院附属第一医院心血管内科,张家口075029 [2]北京市中医学校医学临床学科,101101

出　　处：《医学研究杂志》2008年第7期44-46,共3页Journal of Medical Research

摘　　要：目的观察西洛他唑(CS)对冠心病(CHD)患者阿司匹林抵抗(AR)的影响。方法165例冠心病患者按照是否合并糖尿病(DM)分为A组:冠心病组,B组:冠心病合并糖尿病组。两组患者均口服阿司匹林(ASA)0.1g,qd,1周后测定二磷酸腺苷(ADP)及花生四烯酸(AA)诱导的血小板聚集率(PAG)。随后将A、B两组患者分别随机分成A1、A2、B1、B2四组。A1、B1两组继续服用阿司匹林0.1qd,A2、B2组加用西洛他唑50mgbid,1周后复查PAG,比较各组PAG和AR的发生情况并进行统计分析。结果A组PAG及AR发生率较B组低(P<0.01)。A1组PAG及AR与A组无明显差异(P>0.05);A2组PAG及AR较A组A1组有明显差异(P<0.01);B1组PAG及AR较B组无明显差异(P>0.05);B2组PAG及AR较B组及B1组有明显降低(P<0.01);A2组PAG及AR与B2组有统计学差异(P<0.05)。结论合并糖尿病的冠心病患者血小板聚集率及阿司匹林抵抗的发生率高于单纯冠心病患者;阿司匹林联合西洛他唑可进一步降低冠心病患者血小板聚集率,减少阿司匹林抵抗的发生,合并糖尿病的冠心病患者获益更大。Objective To study the influence of cilostazol to aspirin resistance in patients with coronary heart disease. Methods A total of 165 patients with coronary heart disease were set apart two groups：group A：coronary heart disease, group B：coronary heart disease by 2 - diabetes mellitus, Both group A and group B received 100 mg of aspirin daily for 7 days and no other antiplatelet agent. The blood samples were analyzed by platelet aggregation（PAG） test. Platelet aggregation using adenosine diphosphate（ADP） and arachidonic acid （AA） . then two groups were randomized four groups： A1, A2, B1 , B2 separately, both group A1 and Blreceived aspirin 100 mg qd continuely, group A2 and B2 added anther antiplatelet drug cilostazol 50 mg bid, redetected platelet aggregation after a week . compared PAG and AR using statistic methods. Results PAG and AR of group A is lower than group B （P 〈 0.01 ）. Compared group A with groupA1, the differences was not discovered on PAG and AR （P 〉 0.05 ）. The PAG and AR of group A2 was significantly lower than group A and group A1 （P 〈0.01 ）. Compared group B1 and B, the difference was not discovered on PAG and AR （P 〉0.05）, the PAG and AR of group B2 is significantly lower than group B and group B1 （ P 〈0.01 ）. the PAG and AR of group A2 were lower than group B2. Conclusion The PAG and AR in patients of coronary heart disease by 2 - diabetes mellitus was higher than it in the patients of coronary heart disease purely. The therapy of combined aspirin and cilostazol can decreased the PAG and AR in patients with coronary heart disease . the benefit of the therapy is larger in patients with coronary heart disease by 2 - diabetes mellitue.

关 键 词：西洛他唑 阿司匹林抵抗 冠心病 2型糖尿病 血小板聚集率 

分 类 号：R971.1[医药卫生—药品] R541.4[医药卫生—药学]