吸烟减弱了阿司匹林的抗凝效应

2006-10-05 00:00 来源:丁香园 作者:cnzifeng 译
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纽约(路透社健康版):新的研究发现,血细胞能通过增强血小板的活性有助于凝血,而吸烟可能会减弱阿司匹林的抗凝作用。
 
对患有心脏病或者中风的患者,通常推荐每日服用小剂量阿司匹林抑制血小板聚集堵塞血管。

Michael Domanski 博士接受路透社健康版采访时说:“阿司匹林及其它抗血小板治疗对预防心脏病发作和中风极其重要。如何更准确地预测这些药物对某个特定个体的作用,对公共卫生事业有极其重要意义。”

马里兰Bethesda国家心肺和血液研究所的Domanski博士和他的同事们在《美国心脏病杂志》中报道,他们进行的一项研究旨在明确哪些因素预示患者对阿司匹林的抗凝作用反应差。

该项研究中123个患者中大约有1/3是吸烟者。年龄从21到95岁。大约一半个体是女性,并且很多患者患有高血压和心脏疾病。

66个患者每天服用81mg的低剂量阿司匹林,测试显示其中8个人对药物没有反应。剂量增加至每天325mg,只有一个人仍为抵抗。

其余57例每天服用阿司匹林325mg的患者中,三例耐药。加用另一种抗血小板药Plavix,4小时后检测显示两个患者对药物有了反应。

最终的分析显示,吸烟者阿司匹林抵抗的发生率是不吸烟者的将近12倍。因此,研究者们认为该发现“更加强调了戒烟的重要性。”

来自:《美国心脏病杂志》2006年9月。

Smoking weakens anti-clotting effect of aspirin

Reuters Health

Monday, October 2, 2006

By David Douglas

NEW YORK (Reuters Health) - By increasing the activity of platelets, blood cells that help clot the blood, smoking may weaken the anti-clotting effect of aspirin, new research suggests.

A small daily dose of aspirin is usually recommended for patients who have had a heart attack or stroke to prevent platelets from building up and blocking critical blood vessels.

"Aspirin and other antiplatelet treatments are central to the prevention of heart attack and stroke," Dr. Michael Domanski told Reuters Health. "A clearer understanding of how to best predict the level of protection provided in a specific individual is a research question of potentially great public health importance."

As they report in the American Journal of Cardiology, Domanski of the National Heart, Lung and Blood Institute in Bethesda, Maryland and colleagues conducted a study to determine which factors predict a poor anti-clotting response to aspirin.

About one third of the 123 patients in the study were smokers. Their ages ranged from 21 to 95 years. About half of the subjects were women and most had high blood pressure, as well as heart disease.

Sixty-six patients were taking low-dose aspirin at 81 milligrams per day, and tests showed that eight of them did not respond to the drug. When the dose was increased to 325 mg per day, only one remained resistant.

In the other 57 patients, who were taking 325 mg of aspirin per day, three were resistant. When they were given a dose of clopidogrel (Plavix), another anti-platelet drug, and tested 4 hours later, two had become responders.

In the final analysis, smokers were nearly 12-times more likely to be resistant to aspirin than were non-smokers. Thus, the researchers conclude, the finding "adds still more weight to the importance of abstinence from smoking."

SOURCE: American Journal of Cardiology, September 2006.


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编辑: 张靖

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