Keber I, Jerse M, Keber D, Stegnar M
Br J Clin Pharmacol. 1979 Mar;7(3):287-91. doi: 10.1111/j.1365-2125.1979.tb00934.x.
Antiaggregating agents are frequently prescribed alone or together with β-adrenergic receptor blocking agents in patients after myocardial infarction. The present study was designed to examine the effects of combined treatment with propranolol and acetylsalicylic acid (ASA) on platelet aggregability. Spontaneous platelet aggregation and aggregation induced by fibrinogen and adrenaline were studied in a group of patients with coronary heart disease before treatment, after treatment with propranolol (0.75-1.0 mg/kg daily), and after combined treatment with propranolol in same dose and ASA (20-25 mg/kg daily). Twenty-one patients with stable angina pectoris and/or after myocardial infarction and twelve healthy men were included in the study. There were no significant differences in both spontaneous and induced platelet aggregation between patient and control group before treatment. Propranolol influenced fibrinogen-induced aggregation: it lowered maximal amplitude of aggregation ( < 0.05), but it did not change the reaction time. ASA in combination with propranolol affected both spontaneous and induced aggregation: it diminished the number of pathological spontaneous aggregations ( < 0.025), it inhibited the second wave of adrenaline-induced aggregation ( < 0.01), prolonged the reaction time of fibrinogen-induced aggregation ( < 0.01) and lowered the maximal amplitude of aggregation ( < 0.05). The study showed that propranolol besides its well-known hemodynamic effects had an additional antiaggregating property. The action of combined treatment with propranolol and ASA on platelet aggregation is probably additive.
抗血小板聚集剂常用于心肌梗死后患者，可单独使用，也可与β-肾上腺素能受体阻滞剂联合使用。本研究旨在探讨普萘洛尔与乙酰水杨酸（ASA）联合治疗对血小板聚集性的影响。对一组冠心病患者在治疗前、服用普萘洛尔（每日0.75 - 1.0mg/kg）后以及服用相同剂量普萘洛尔与ASA（每日20 - 25mg/kg）联合治疗后，研究其血小板自发聚集以及由纤维蛋白原和肾上腺素诱导的聚集情况。21例稳定型心绞痛患者和/或心肌梗死后患者以及12名健康男性纳入本研究。治疗前患者组与对照组在血小板自发聚集和诱导聚集方面均无显著差异。普萘洛尔影响纤维蛋白原诱导的聚集：降低了最大聚集幅度（<0.05），但未改变反应时间。ASA与普萘洛尔联合使用对自发聚集和诱导聚集均有影响：减少了病理性自发聚集的数量（<0.025），抑制了肾上腺素诱导聚集的第二波（<0.01），延长了纤维蛋白原诱导聚集的反应时间（<0.01）并降低了最大聚集幅度（<0.05）。研究表明，普萘洛尔除了其众所周知的血流动力学作用外，还具有额外的抗聚集特性。普萘洛尔与ASA联合治疗对血小板聚集的作用可能具有相加性。
