Cattaneo M, Chahil A, Somers D, Kinlough-Rathbone R L, Packham M A, Mustard J F
Blood. 1983 Feb;61(2):353-61.
We have studied the effect of different doses of aspirin on platelet function, PGI2 formation, platelet survival, thrombosis, fibrinolysis, and prothrombin time in rabbits with indwelling aortic catheters. The thrombi formed around indwelling aortic catheters were found to have a large fibrin component, and their formation was inhibited by heparin administration. Thus, in these experiments we examined the effect of aspirin (a weak inhibitor of thrombin-mediated platelet aggregation) under conditions in which thrombin was a major factor in the initiation and growth of the thrombi. Only very high doses of aspirin tended to inhibit thrombus formation over the 5-day period of observation, and a statistically significant inhibition of thrombus formation was produced by equivalent concentrations of sodium salicylate. The failure of high doses of aspirin to achieve a significant inhibition of thrombosis under the conditions of these experiments (whereas an equivalent dose of sodium salicylate was inhibitory) could be due to aspirin inhibition of PGI2 formation. Shortened platelet survival was not affected by aspirin treatment or the dose sodium salicylate that inhibited thrombus formation. The tendency to inhibit thrombus formation appeared to be unrelated to an effect on platelets but was associated with prolongation of the one-stage prothrombin time and increased whole blood fibrinolytic activity; doses of aspirin that inhibited platelet aggregation in response to sodium arachidonate or collagen, and PGI2 formation by the vessel wall, did not have a significant effect on the amount of thrombus present at 5 days. However, the high doses of aspirin that inhibited PGI2 formation were associated with a tendency to increased thrombus formation during the first 3 hr after insertion of the catheter. The results of these experiments show that when thrombin is an important factor in the formation of thrombi, aspirin is a weak inhibitor of thrombosis unless doses are used that provide sufficient salicylate to interfere with blood coagulation and promote whole blood fibrinolytic activity. These results also show that thrombus formation can be inhibited without an apparent change in platelet survival.
我们研究了不同剂量阿司匹林对留置主动脉导管的家兔血小板功能、前列环素(PGI2)生成、血小板存活、血栓形成、纤维蛋白溶解及凝血酶原时间的影响。发现留置主动脉导管周围形成的血栓含有大量纤维蛋白成分,肝素给药可抑制其形成。因此,在这些实验中,我们在凝血酶是血栓形成和生长的主要因素的条件下,研究了阿司匹林(凝血酶介导的血小板聚集的弱抑制剂)的作用。在5天的观察期内,只有非常高剂量的阿司匹林倾向于抑制血栓形成,而等效浓度的水杨酸钠可产生统计学上显著的血栓形成抑制作用。在这些实验条件下,高剂量阿司匹林未能显著抑制血栓形成(而等效剂量的水杨酸钠具有抑制作用)可能是由于阿司匹林抑制了PGI2的生成。血小板存活时间缩短不受阿司匹林治疗或抑制血栓形成的水杨酸钠剂量的影响。抑制血栓形成的倾向似乎与对血小板的作用无关,而是与一期凝血酶原时间延长和全血纤维蛋白溶解活性增加有关;抑制对花生四烯酸钠或胶原的血小板聚集以及血管壁PGI2生成的阿司匹林剂量,对5天时存在的血栓量没有显著影响。然而,抑制PGI2生成的高剂量阿司匹林与导管插入后最初3小时内血栓形成增加的倾向有关。这些实验结果表明,当凝血酶是血栓形成的重要因素时,阿司匹林是血栓形成的弱抑制剂,除非使用能提供足够水杨酸盐以干扰血液凝固并促进全血纤维蛋白溶解活性的剂量。这些结果还表明,在血小板存活无明显变化的情况下,血栓形成可被抑制。