Greer I A
Department of Obstetrics and Gynaecology, University of Edinburgh, Scotland, United Kingdom.
Pharmacotherapy. 1990;10(6 ( Pt 2)):71S-76S.
Ketorolac tromethamine is a potent prostaglandin synthetase inhibitor useful in the treatment of postoperative pain. Since it is also known to have antiplatelet properties, we determined the effect of ketorolac, alone and in combination with low-dose heparin, on hemostasis. Each of 12 healthy male volunteers received the following drug combinations on a double-blind, crossover basis: ketorolac dummy/heparin dummy, ketorolac active/heparin dummy, ketorolac active/heparin active, and ketorolac dummy/heparin active. Ketorolac significantly prolonged bleeding time, and inhibited platelet aggregation and platelet thromboxane production. Heparin had no effect on bleeding time or platelet function, but significantly prolonged the kaolin-cephalin clotting time and increased anti-Xa levels. Ketorolac had no effect on the kaolin-cephalin clotting time or anti-Xa levels, and no interaction was found between ketorolac and heparin. The modest prolongation of bleeding time with ketorolac is unlikely to be of any major clinical significance, as the value remained within the normal range in almost all subjects. However, because of its antiplatelet properties, the drug should be used with caution in persons with hemostatic disorders.
酮咯酸氨丁三醇是一种有效的前列腺素合成酶抑制剂，可用于治疗术后疼痛。由于已知它还具有抗血小板特性，我们确定了酮咯酸单独使用以及与小剂量肝素联合使用对止血的影响。12名健康男性志愿者每人在双盲、交叉的基础上接受以下药物组合：酮咯酸安慰剂/肝素安慰剂、酮咯酸活性药/肝素安慰剂、酮咯酸活性药/肝素活性药、酮咯酸安慰剂/肝素活性药。酮咯酸显著延长出血时间，并抑制血小板聚集和血小板血栓素生成。肝素对出血时间或血小板功能无影响，但显著延长高岭土-脑磷脂凝血时间并提高抗Xa水平。酮咯酸对高岭土-脑磷脂凝血时间或抗Xa水平无影响，且未发现酮咯酸与肝素之间存在相互作用。酮咯酸导致出血时间适度延长，这在几乎所有受试者中该值仍保持在正常范围内，因此不太可能具有任何重大临床意义。然而，由于其抗血小板特性，该药物在有止血障碍的人群中应谨慎使用。
