Dereska Nina H, McLemore Elisabeth C, Tessier Deron J, Bash Deborah S, Brophy Colleen M
Division of Gynecologic Surgery, Mayo Clinic Arizona, Scottsdale, USA.
J Surg Res. 2006 May;132(1):121-9. doi: 10.1016/j.jss.2005.09.031. Epub 2005 Dec 9.
To investigate the in vivo effect of short-term, moderate dosage synthetic dl-alpha-tocopherol acetate supplementation on platelet aggregation, coagulation profile, and simulated bleeding time in healthy individuals. alpha-tocopherol is the most biologically active isomer of Vitamin E, traditionally promoted as an antioxidant and therapeutic agent in cardiovascular disease. In vitro studies have suggested that alpha-tocopherol plays a role in the inhibition of platelet aggregation. However, further investigations into the effect of alpha-tocopherol on bleeding in vivo have not duplicated these findings.
A total of 42 healthy volunteers complied with a 2-week abstinence period from the use of anti-platelet agents followed by determination of baseline platelet aggregation properties and coagulation studies using citrated whole blood. Moderate dosage Vitamin E (800 IU of dl-alpha-tocopherol acetate) was then self-administered for 14 days with reevaluation of platelet aggregation and coagulation profile, and simulated bleeding time after 14 days of Vitamin E supplementation.
Forty subjects completed the 4-week study period. All 40 subjects demonstrated normal baseline coagulation studies and all had collagen-stimulated platelet aggregation assessment performed in triplicate. After Vitamin E supplementation, no significant difference was demonstrated in any study parameter.
Dietary supplementation with moderate dosage synthetic dl-alpha-tocopherol acetate did not significantly prolong bleeding or platelet aggregation in vivo. The affect of Vitamin E on platelet aggregation in vitro does not appear to be reproducible in vivo. Therefore, peri-operative discontinuation of Vitamin E may not be necessary.
研究短期、中等剂量合成dl-α-生育酚醋酸酯补充剂对健康个体血小板聚集、凝血指标及模拟出血时间的体内影响。α-生育酚是维生素E最具生物活性的异构体,传统上被认为是心血管疾病中的抗氧化剂和治疗剂。体外研究表明,α-生育酚在抑制血小板聚集中起作用。然而,对α-生育酚体内出血影响的进一步研究并未重复这些发现。
共有42名健康志愿者在停用抗血小板药物2周后,使用枸橼酸化全血测定基线血小板聚集特性和凝血指标。然后自行服用中等剂量维生素E(800 IU dl-α-生育酚醋酸酯)14天,并在补充维生素E 14天后重新评估血小板聚集、凝血指标及模拟出血时间。
40名受试者完成了为期4周的研究期。所有40名受试者的基线凝血指标均正常,且均对胶原刺激的血小板聚集评估进行了三次重复检测。补充维生素E后,任何研究参数均未显示出显著差异。
饮食中补充中等剂量合成dl-α-生育酚醋酸酯在体内不会显著延长出血时间或影响血小板聚集。维生素E对体外血小板聚集的影响在体内似乎无法重现。因此,围手术期可能无需停用维生素E。