Prichard P J, Kitchingman G K, Walt R P, Daneshmend T K, Hawkey C J
Department of Therapeutics, University Hospital, Nottingham.
BMJ. 1989 Feb 25;298(6672):493-6. doi: 10.1136/bmj.298.6672.493.
To investigate the suitability of treatment with low dose aspirin or warfarin, or both, as possible prophylaxis against cardiovascular disease by determining the effect on gastric mucosal bleeding.
Randomised crossover trial.
Academic department of therapeutics.
Twenty healthy male volunteers aged 19-22.
On separate occasions and in randomised order all subjects received aspirin 75 mg, warfarin, or aspirin 75 mg combined with warfarin. Each treatment was given for 12 days or (when warfarin was used) for longer if necessary until the international normalised ratio of the prothrombin time was stable at 1.4-1.6.
Loss of blood over 10 minutes into gastric washings.
Bleeding over 10 minutes into gastric washings under baseline conditions and after five days, and at end of each regimen of treatment. Aspirin 75 mg increased bleeding from 0.60 (95% confidence interval 0.36 to 0.99) microliters/10 minutes to 1.26 (0.71 to 2.25) microliters/10 minutes at five days, with no evidence of either progressive change or adaptation thereafter. Warfarin had no effect on bleeding either alone or when combined with aspirin.
Aspirin 75 mg causes gastric mucosal bleeding. Low dose warfarin neither induces gastric mucosal bleeding nor enhances that caused by aspirin.
通过测定低剂量阿司匹林或华法林或两者联合使用对胃黏膜出血的影响，研究其作为预防心血管疾病措施的适用性。
随机交叉试验。
治疗学学术部门。
20名年龄在19至22岁之间的健康男性志愿者。
所有受试者在不同时间以随机顺序分别接受75毫克阿司匹林、华法林或75毫克阿司匹林与华法林联合用药。每种治疗持续12天，或（使用华法林时）必要时延长用药时间，直至凝血酶原时间的国际标准化比值稳定在1.4至1.6。
10分钟内胃灌洗液中的失血量。
在基线条件下、五天后以及每种治疗方案结束时，测量10分钟内胃灌洗液中的出血量。75毫克阿司匹林使五天后的出血量从0.60（95%置信区间0.36至0.99）微升/10分钟增加到1.26（0.71至2.25）微升/10分钟，此后没有证据表明有进一步变化或适应性改变。华法林单独使用或与阿司匹林联合使用时对出血均无影响。
75毫克阿司匹林可导致胃黏膜出血。低剂量华法林既不会引起胃黏膜出血，也不会增强阿司匹林所致的胃黏膜出血。
