葛根素对阿司匹林抵抗患者血小板功能影响的临床研究

摘要

目的 研究葛根素对阿司匹林抵抗患者血小板功能的影响.方法 采用单中心双盲、对照临床试验共入选180例冠心病住院患者,以花生四烯酸诱导的血小板聚集率>50%和二磷酸腺苷诱导的血小板聚集率≥70%作为血小板高反应性的标准,将患者随机分成葛根素+氯吡格雷组(葛根素组)和阿司匹林+氯吡格雷组(阿司匹林组),比较第3天和第7天后患者的血小板功能及相关生化指标.结果 与阿司匹林组比较,葛根素组在第3天和第7天均可明显改善AA途径诱导的血小板抑制率(P < 0.01),在第3天可以更好地抑制ADP途径诱导的血小板聚集(P < 0.05);葛根素组同样可以显著降低TXA2代谢相关产物水平(P < 0.05).结论 葛根素可以有效改善阿司匹林抵抗患者中的血小板高反应性,有助于达到理想的血小板抑制水平.%Objective To evaluate the effect of Puerarin on plateletinhibition functions in patients with Aspirin resistance. Methods A single-center double-blinded controlled clinical trial was designed in which totally 180 patients were enrolled with high platelet response (AA-induced aggregation>50% and ADP-induced aggregation ≥ 70% with TEG protocol). All patients were divided into two groups including Puerarin+Clopidogrel group (Puerarin group) and Aspirin+Clopidogrel group (Aspirin group). The platelet aggregation functions, as well as relative TXA2 metabolic product biomarker were measured in indicated time. Results On 3rd and 7th day, AA-induced platelet inhibition percentage can be significantly improved in Puerarin group than that in Aspirin group (P < 0.01). Puerarin group could also obtain better ADP-induced platelet inhibition percentage than Aspirin group (P < 0.05) on 3rd day. As to TXA2 metabolite, urinary 11-DH-TXB2 could be significantly reduced in PC group compared with Aspirin group both on 3rd and 7th day (P < 0.05). Conclusion Puerarin can effectively improve high platelet response in patients with Aspirin resistance, and thus help reach an ideal level for platelet inhibition.