Abaci Adnan, Yilmaz Yucel, Caliskan Mustafa, Bayram Fahri, Cetin Mustafa, Unal Ali, Cetin Servet
Department of Cardiology, Gazi University School of Medicine, Ankara 06550, Turkey.
Thromb Res. 2005;116(6):465-70. doi: 10.1016/j.thromres.2005.02.005.
Platelets of diabetic patients have been reported to be less sensitive to aspirin. The aim of this study is to compare a medium (300 mg) and low (100 mg) dose of aspirin on platelet function in diabetic patients.
We have included one hundred and two patients with type 2 diabetes mellitus. Platelet function was measured as closure time (CT) with the Platelet Function Analyzer (PFA)-100 before the administration of aspirin. Initially the patients were given 100 mg aspirin once daily for seven days, and then the measurements were repeated. If the CT exceeded the upper limit of 300 s, the study was terminated. If not, the patients continued the aspirin therapy with a dose of 300 mg daily for another seven days, and the CTs were measured again.
After taking 100 mg aspirin, the CT significantly increased from 126+/-29 s to 256+/-66 s (p<0.001). In 68 of 102 (67%) patients, the CT increased to 300 s. In the remaining 34 patients, the baseline CT was 113+/-29, and increased to 170+/-45 s after 100 mg aspirin (p<0.001). In these patients, there was a further increase in the CT from 170+/-45 to 229+/-75 s following 300 mg aspirin (p<0.001). On average, the CT was increased by 60% and 39% following ingestion of 100 and 300 mg aspirin, respectively. CT>300 s were obtained in 15 (44%) of 34 patients after 300 mg aspirin.
Although, a daily dose of 100 mg aspirin effectively inhibited platelet function in a majority of diabetics, a considerable proportion of patients showed a greater platelet inhibition with the use of 300 mg aspirin. The PFA-100 closure time may be used to separate those patients who require a higher dose of aspirin to achieve desired antiplatelet effect.
据报道，糖尿病患者的血小板对阿司匹林的敏感性较低。本研究的目的是比较中等剂量（300毫克）和低剂量（100毫克）阿司匹林对糖尿病患者血小板功能的影响。
我们纳入了102例2型糖尿病患者。在服用阿司匹林前，使用血小板功能分析仪（PFA）-100以封闭时间（CT）来测量血小板功能。最初，患者每天服用100毫克阿司匹林，持续7天，然后重复测量。如果CT超过300秒的上限，则终止研究。如果未超过，则患者继续以每日300毫克的剂量服用阿司匹林，持续7天，然后再次测量CT。
服用100毫克阿司匹林后，CT从126±29秒显著增加至256±66秒（p<0.001）。102例患者中有68例（67%）的CT增加到300秒。在其余34例患者中，基线CT为113±29秒，服用100毫克阿司匹林后增加到170±45秒（p<0.001）。在这些患者中，服用300毫克阿司匹林后，CT从170±45秒进一步增加到229±75秒（p<0.001）。平均而言，服用100毫克和300毫克阿司匹林后，CT分别增加了60%和39%。34例患者中有15例（44%）在服用300毫克阿司匹林后CT>300秒。
虽然每日100毫克阿司匹林能有效抑制大多数糖尿病患者的血小板功能，但相当一部分患者使用300毫克阿司匹林时血小板抑制作用更强。PFA-100封闭时间可用于区分那些需要更高剂量阿司匹林以达到理想抗血小板效果的患者。
