【摘要】 目的初步探讨原发性高血压患者的阿司匹林抵抗(AR)情况及其与尿血栓素B2(TXB2)的关系。方法EH患者147例和健康体检者33例服用阿司匹林100mg/d≥1周后,分别用花生四烯酸(AA)、二磷酸腺苷(ADP)作诱导剂检测血小板聚集率(PAG),并测定其尿TXB2的含量。AA诱导的血小板平均聚集率≥20%,同时ADP诱导的血小板平均聚集率≥70%者为AR;仅符合其中一项为阿司匹林半抵抗(ASR);均不符合者为阿司匹林敏感(AS)。结果原发性高血压组AR发生率为16.33%(24例),ASR发生率是8.84%(13例);AR、ASR患者尿TXB2浓度与AS患者比较,差异有统计学意义(F=54.43,P<0.05);对照组AR、ASR发生率分别为3.03%(1例)、15.15%(5例);原发性高血压组AR发生率与对照组比较,差异有统计学意义(χ2=4.07,P<0.05);AA诱导的PAG(23.08±21.03%)显著高于对照组(11.88±8.02)%(t=5.03,P<0.05)。两组间ASR、AR+ASR发生率差异无统计学意义(χ2分别=1.19、0.73,P均>0.05)。180例入选者尿TXB2浓度与ADP诱导的PAG正相关(r=0.51,P<0.05)。结论原发性高血压患者阿司匹林疗效降低,AR发生率升高;AR或ASR者尿TXB2浓度较高。更多还原

【Abstract】 Objective To investigate aspirin resistance(AR) in essential hypertension(EH) patients and its relationship with urinary TXB 2. Methods EH group( n=147) and control group( n=33) took aspirin 100 mg/d more than 7 days, and then their blood samples were collected for determination of platelet aggregation(PAG) rates using arachidonic acid(AA) and adenosine diphosphate(ADP),and urinary TXB 2 levels were detected. AR was defined as a state of aggregation ≥20% with AA and ≥70% with ADP. Aspirin semiresistance (ASR) was defined as meeting one of the above criteria. If both above criteria were not met, the condition was defined as aspirin sensitive(AS). Results In EH group, 16.33% patients were AR and 8.84% patients were ASR.The urinary level of TXB 2 in AS subgroup had significant differences with that in AR subgroup and ASR subgroup( F=54.43, P<0.05). In control group, 3.03% were AR while 15.15% patients were ASR. The incidence of AR in EH group was higher than that in control group (χ 2=4.07, P<0.05).AA-induced PAG in EH group was higher than that in control group (23.08±21.03% vs 11.88±8.02%, t=5.03, P<0.05).There was no statistics difference between the two groups in the incidence of ASR and AR+ASR(χ 2=1.19,0.73, P>0.05). The TXB 2 level in all patients correlated with ADP-induced PAG ( r=0.511, P<0.05).Conclusion The incidence of AR among EH patients increased. The urinary levels of TXB 2 in AR or ASR patients were higher.更多还原