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1、阿司匹林抵抗非瓣膜性房颤探究【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：二磷酸腺酉干(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%
2、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
3、文献标识码：AStudyofaspirinresistanceinnon-valvulara/trialfibrillationYANGHui-jianl,YUXi-fa2,CHENYun-el(1.ThePeople'sHospitalofDongxiang,Jiangxi331800,China；2.DongxiangHospitalofTraditionalChineseMedicine,Jiangxi331800,China)【Abstract】Objective:Tostudythepossibleinflue
4、ncingfactorsofaspirinresistance(AR)innon-valvularatrialfibrillation(NVAF)anditsanticipationindices.Methods:20NVAFpatientswithcerebralinfarction,whohadtakenlong-termaspirinbeforetheoccurenceofthrombosiswereinvolvedasaspirinresistancegroup(ARgroup)；28NVAFpatientswi
5、thoutcerebralinfarction,whohadtakenlong-termaspirintooservedasaspirinsensitivitygroup(ASgroup).TheplateletaggregationrateinducedbyADPandEPIwasmeasuredbyopticalpla.teletagglutometer,whiletheCRPandbloodlipidsweremeasuredbycommonserumchemicalimmunizationandenzymicme
6、thodrespectively.Results：TheratesofADPPAG(M),ADPPAG(l),EPIPAG(M)andEPIPAG(l)inARgroupwerehigherthanthoseinASgroup・ThecaseproportionalnumberofADPPAG(M)>60%,EPIPAG(M)>60%andbothofthem>60%inARgroupwashigherthanthatinASgroup・TCandLDL-CinARgroupwerehigherthanthoseinAS
7、group,theaspirindosageinARgroupwaslowerthanthatinASgroup,therewasnosignificantdifferenceintheserumCRPbetweentwogroups.Conclusion：CerebralinfarctionmaybecloselycorrelatedwithplateletaggregationenhancementinNVAF,thedosageinadequacyofaspirinisoneofthefactorsleadingt
8、oARprobably.HigherTCandLDL-CmaybeoneofthefactorsprovokingAR,CRPmeasuredbycommunserumchemicalimmunizationdoesnotsuggesttheroleonthesepatientswithNVAFdevelopingA
