Department of Neurosurgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Department of Neurosurgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
World Neurosurg. 2014 Nov;82(5):e633-8. doi: 10.1016/j.wneu.2014.03.043. Epub 2014 Mar 31.
To help define the perioperative risk related to commonly used non-aspirin NSAIDs with whole blood platelet aggregometry.
Twelve healthy volunteers were recruited. Two cyclooxygenase (COX)-1 inhibitors (ibuprofen and naproxen) and two COX-2 inhibitors (meloxicam and celecoxib) were administered, and daily whole blood platelet aggregometry studies were obtained until studies showed no platelet inhibition. Aspirin was studied at the conclusion of the study.
Ibuprofen had no inhibitory effect on platelet aggregation in all women and no inhibitory effect in 83% of men at 24 hours. All platelet function had returned to normal at 48 hours. The inhibitory effect of naproxen on platelets was absent at 48 hours in 83% of the women and 50% of men. By 72 hours all platelet studies had returned to normal. Meloxicam and celecoxib did not cause any overall inhibitory effect on platelet aggregation.
Ibuprofen and naproxen have a mild inhibitory effect on platelet aggregation compared with aspirin and this effect is undetectable by 48 hours and 72 hours, respectively. Meloxicam and celecoxib show essentially no inhibitory effect on platelet aggregation. These findings suggest that there is little bleeding risk related to platelet aggregation at 24 hours in patients who take COX-2 inhibitors and at 72 hours for those who take COX-1 inhibitor medications.
使用全血血小板聚集测定法，帮助确定与常用非阿司匹林 NSAIDs 相关的围手术期风险。
招募了 12 名健康志愿者。给予两种环氧化酶（COX）-1 抑制剂（布洛芬和萘普生）和两种 COX-2 抑制剂（美洛昔康和塞来昔布），直至研究表明无血小板抑制作用，每天进行全血血小板聚集测定研究。在研究结束时研究了阿司匹林。
布洛芬在所有女性中对血小板聚集均无抑制作用，在 24 小时内 83%的男性也无抑制作用。所有血小板功能在 48 小时内均恢复正常。在 83%的女性和 50%的男性中，萘普生在 48 小时内对血小板无抑制作用。到 72 小时，所有血小板研究均恢复正常。美洛昔康和塞来昔布均未引起血小板聚集的总体抑制作用。
与阿司匹林相比，布洛芬和萘普生对血小板聚集有轻度抑制作用，分别在 48 小时和 72 小时后检测不到这种作用。美洛昔康和塞来昔布对血小板聚集几乎没有抑制作用。这些发现表明，在服用 COX-2 抑制剂的患者中，在 24 小时内，以及在服用 COX-1 抑制剂药物的患者中，在 72 小时内，与血小板聚集相关的出血风险很小。
