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低剂量阿司匹林疗法?

A regimen for low-dose aspirin?

作者信息

Hanley S P, Bevan J, Cockbill S R, Heptinstall S

出版信息

Br Med J (Clin Res Ed). 1982 Nov 6;285(6351):1299-302. doi: 10.1136/bmj.285.6351.1299.

Abstract

The effects of different regimens of 40 mg aspirin on platelet thromboxane A2 synthesis and vascular prostacyclin synthesis were determined in patients who were undergoing elective surgery for removal of varicose veins. Aspirin 40 mg taken at intervals of 48 hours consistently reduced platelet thromboxane A2 synthesis to a level at which it failed to support platelet aggregation and the associated release reaction. This effect lasted for at least 36 hours. In contrast, aspirin 40 mg every 72 hours did not have the same consistent effect. Both dose regimens led to a reduction in vascular prostacyclin synthesis 12 hours after the last dose, but 36 or 72 hours after the last dose prostacyclin synthesis was not reduced; thus the inhibition of prostacyclin synthesis was short lived. If the balance between platelet thromboxane A2 and vascular prostacyclin synthesis is important in thrombosis 40 mg aspirin every 48 hours may have the maximum antithrombotic effect.

摘要

在接受择期手术以切除静脉曲张的患者中,测定了40毫克阿司匹林不同给药方案对血小板血栓素A2合成和血管前列环素合成的影响。每48小时服用一次40毫克阿司匹林可持续将血小板血栓素A2合成降低至无法支持血小板聚集及相关释放反应的水平。该作用持续至少36小时。相比之下,每72小时服用一次40毫克阿司匹林则没有同样稳定的效果。两种给药方案在最后一剂后12小时均导致血管前列环素合成减少,但在最后一剂后36或72小时,前列环素合成并未减少;因此,对前列环素合成的抑制是短暂的。如果血小板血栓素A2与血管前列环素合成之间的平衡在血栓形成中很重要,那么每48小时服用40毫克阿司匹林可能具有最大的抗血栓作用。

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