倾向值匹配法分析老年人群阿司匹林剂量与阿司匹林抗血小板作用的相关性  

Correlation between dosage and antiplatelet effect of aspirin in elderly population

作　　者：李晓利[1] 王永吉[2] 范利[3] 陈昕[1] 张金花[1] 马聪 张荣强 苏轮[1] 胡超[1] 

机构地区：[1]解放军309医院干部病房,北京100091 [2]解放军309医院干部医务部,北京100091 [3]解放军总医院南楼临床部 [4]健康管理研究院国际部三科 [5]海军丰台干休所

出　　处：《中华老年心脑血管病杂志》2015年第9期925-928,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：国家自然科学基金(81300252)

摘　　要：目的倾向值匹配法分析阿司匹林抗血小板作用是否对阿司匹林剂量存在依赖性。方法收集2008年4月～2010年7月驻京干休所530例老年患者资料,根据每日服用阿司匹林剂量分为3组：未用阿司匹林40例为空白对照组,25～50mg组24例,75～100mg组466例。用花生四烯酸诱导光比浊法检测血小板聚集率,血小板聚集率≥20%诊断为血小板高反应性。采用倾向值匹配法,将3组性别、年龄、体质量指数、吸烟、饮酒、基础疾病、服心血管病药物等14个协变量完全匹配分析。结果空白对照组,25～50mg组,75～100mg组的血小板高反应性发生率分别为72.50%,37.50%,13.73%,3组比较差异有统计学意义（χ2=87.25,P〈0.01）。经倾向值匹配后,每组各17例患者临床基线完全匹配,空白对照组,25～50mg组,75～100mg组的血小板高反应性发生率分别为82.35%,47.06%,11.76%,3组比较差异有统计学意义（χ2=17.00,P〈0.01）。结论服用阿司匹林剂量在0～100mg变动,抗血小板作用对阿司匹林剂量有依赖性,多数口服≤50mg/d的阿司匹林患者达不到抗血小板作用。Objective To study whether the antiplatelet effect of aspirin is dependent on its dosage. Methods Five hundred and thirty elderly patients in Beijing admitted to our hospital from April 2008 to June 2010 were divided into control group （n=40）,25--50 mg aspirin treatment group （n=24） ,and 75-100 mg aspirin treatment group （n=446）. Their platelets were detected by AA- induced phototurbimetry. High platelet reactivity （HPR） was defined when the platelet aggrega- tion was ≥20%. The sex, age, BMI, smoking,alcohol comsuption, history of diseases,and use of anti-cardiovascular disease drugs were analyzed by PSM. Results The HPR was 72. 50%, 37.50% and 13.73% respectively in control group,25--50 mg aspirin treatment group and 75-- 100 mg aspirin treatment group （x2 =87.25,P〈0.01）. PSM showed full matching in 51 patients （17 in each group） and a HPR of 82.35%,47.06% and 11.76% in the 3 groups （Z2 =17.00,P〈 0.01）. Conclusion The antiplatelet effect of aspirin is dependent on its dosage （0- 100 rag） and aspirin cannot exert its antiplatelet effect when its oral dosage is 450 rag.

关 键 词：阿司匹林 血小板聚集抑制剂 血小板聚集 危险因素 

分 类 号：R96[医药卫生—药理学]