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全血中血小板对几种激动剂及激动剂组合的反应:一项在人体中进行的安慰剂对照研究,比较每日一次服用300毫克普通阿司匹林、75毫克普通阿司匹林和300毫克肠溶阿司匹林的效果。

Platelet responses to several agonists and combinations of agonists in whole blood: a placebo controlled comparison of the effects of a once daily dose of plain aspirin 300 mg, plain aspirin 75 mg and enteric coated aspirin 300 mg, in man.

作者信息

May J A, Heptinstall S, Cole A T, Hawkey C J

机构信息

Division of Cardiovascular Medicine, University Hospital, Nottingham, UK.

出版信息

Thromb Res. 1997 Oct 15;88(2):183-92. doi: 10.1016/s0049-3848(97)00229-6.

Abstract

Platelet responses to several agonists and combinations of agonists have been measured in whole blood from healthy volunteers. We have determined the effects of once daily treatment for five days with plain aspirin 300 mg, plain aspirin 75 mg, enteric coated aspirin 300 mg or placebo. Measurements were made of platelet aggregation (using a platelet counting technique) and the release reaction (14C-5HT release from pre-labelled platelets). The extents of these responses before aspirin administration depended on the agonist used. ADP, adrenaline and PAF failed to induce any 14C-5HT release in most subjects, but combinations of these agonists acted synergistically to produce extensive 14C-5HT release. All three aspirin preparations reduced the extent of the platelet responses to most agonists: platelet aggregation induced by collagen, ristocetin and arachidonate and 14C-5HT release induced by collagen, streptokinase, and various combinations of ADP, adrenaline and PAF. None of the preparations had any effect on the aggregation that occurred in the absence of an agonist (spontaneous aggregation), but they all reduced streptokinase-induced aggregation to control (spontaneous) levels, and abolished the 14C-5HT release induced by arachidonate and by ristocetin. All three aspirin preparations were equally effective after two daily doses. No further inhibition of platelet responses was obtained after five daily doses. Plain aspirin 300 mg achieved its maximal effect after only a single dose, but enteric coated aspirin 300 mg (and sometimes plain aspirin 75 mg) produced sub-maximal inhibition after only a single dose. Parallel investigations on the effects of these aspirin regimes on gastric mucosal prostaglandin E2 synthesis and gastroduodenal mucosal injury were performed. These results will be reported separately.

摘要

已对健康志愿者全血中血小板对多种激动剂及激动剂组合的反应进行了测定。我们确定了每日一次服用300毫克普通阿司匹林、75毫克普通阿司匹林、300毫克肠溶阿司匹林或安慰剂,连续治疗五天的效果。测量了血小板聚集(采用血小板计数技术)和释放反应(预先标记血小板中的14C - 5HT释放)。阿司匹林给药前这些反应的程度取决于所使用的激动剂。在大多数受试者中,ADP、肾上腺素和PAF未能诱导任何14C - 5HT释放,但这些激动剂的组合协同作用可产生大量14C - 5HT释放。所有三种阿司匹林制剂均降低了血小板对大多数激动剂的反应程度:胶原、瑞斯托霉素和花生四烯酸诱导的血小板聚集,以及胶原、链激酶和ADP、肾上腺素与PAF的各种组合诱导的14C - 5HT释放。没有一种制剂对无激动剂时发生的聚集(自发聚集)有任何影响,但它们都将链激酶诱导的聚集降低至对照(自发)水平,并消除了花生四烯酸和瑞斯托霉素诱导的14C - 5HT释放。每日两次给药后,所有三种阿司匹林制剂的效果相同。每日五次给药后未获得对血小板反应的进一步抑制。300毫克普通阿司匹林仅单次给药后即达到最大效果,但300毫克肠溶阿司匹林(有时75毫克普通阿司匹林)仅单次给药后产生次最大抑制作用。对这些阿司匹林给药方案对胃黏膜前列腺素E2合成和胃十二指肠黏膜损伤的影响进行了平行研究。这些结果将另行报告。

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