De Caterina R, Giannessi D, Bernini W, Gazzetti P, Michelassi C, L'Abbate A, Donato L, Patrignani P, Filabozzi P, Patrono C
Eur Heart J. 1985 May;6(5):409-17. doi: 10.1093/oxfordjournals.eurheartj.a061879.
The adequacy, selectivity and long-term persistence of inhibition in cyclooxygenase-dependent platelet function by a daily low-dose (0.45 mg kg-1 day-1) aspirin treatment have been evaluated in 15 patients after a recent (less than 17 days) acute myocardial infarction. Serum thromboxane (TX) B2, an index of platelet TXA2 production, was decreased by 94-98% (P less than 0.001) by aspirin, while urinary excretion of 6-keto-prostaglandin F1 alpha, as an index of extraplatelet cyclooxygenase activity, remained unchanged. Compared to placebo, aspirin induced a persistent increase in bleeding time (% difference 45.6 +/- 21.4, mean +/- SD) and a decrease in platelet aggregation by ADP, epinephrine, collagen and arachidonic acid. No tendency towards an attenuation of the effects was apparent for the period of aspirin administration (4 weeks). Aspirin 0.45 mg kg-1 day-1 is adequate and selective in the long-term inhibition of TX-related platelet function in patients after acute myocardial infarction. The clinical effectiveness of such a regimen remains to be proven in clinical trials.
对15例近期（不到17天）发生急性心肌梗死的患者，评估了每日低剂量（0.45毫克/千克/天）阿司匹林治疗对环氧合酶依赖性血小板功能抑制的充分性、选择性和长期持续性。阿司匹林使作为血小板血栓素A2生成指标的血清血栓素（TX）B2降低了94 - 98%（P < 0.001），而作为血小板外环氧合酶活性指标的6 - 酮 - 前列腺素F1α的尿排泄量保持不变。与安慰剂相比，阿司匹林使出血时间持续增加（差异百分比45.6 +/- 21.4，平均值 +/- 标准差），并使血小板对ADP、肾上腺素、胶原和花生四烯酸的聚集性降低。在阿司匹林给药期间（4周），未观察到效应减弱的趋势。0.45毫克/千克/天的阿司匹林在长期抑制急性心肌梗死后患者与TX相关的血小板功能方面是充分且有选择性的。这种治疗方案的临床有效性仍有待在临床试验中得到证实。
