复方丹参滴丸治疗冠心病阿司匹林抵抗214例临床疗效观察

摘要

目的:探讨复方丹参滴丸对阿司匹林抵抗的疗效和机制.方法:筛选冠心病阿司匹林抵抗(Aspirin Resistance,AR)和阿司匹林半抵抗(Aspirin Semi-resistance,ASR)患者214例,其中AR44例,ASR170例.入选冠心病患者共828例,男448例,女380例,年龄40～89(61±11.18)岁,在口服阿司匹林基础上,联合口服复方丹参滴丸,每日3次,每次10粒.检测服药前和服药2周后AA和ADP诱导血小板聚集率.结果:AR组、ASR组及AR+ASR患者血小板聚集率显著高于阿司匹林敏感(Aspirin Sensitive,AS)组.214例AR或ASR患者中,103例血小板聚集率达到AS水平(48.13%),42例血小板聚集率下降≥20%,但未达到AS标准.有效率为67.76%,联合用药前后血常规、肝、肾功能无异常.结论:复方丹参滴丸在降低阿司匹林抵抗患者的血小板聚集率方面具有一定疗效,机制可能为多靶点作用,有待进一步探讨.%Objective :To explore efficacy and mechanism of Compound Danshen Dripping Pill. Methods: A total of 214 patients with CHD were selected, including 44 patients with aspirin resistance ( AR ) and 170 patients with Aspirin semi-resistance ( ASR ). Another 828 patients with CHD were selected, including 448 males and 380 females, age between 40 ～ 89 ( 61 ± 11.18 ) years old. On top of Aspirin, Compound Danshen Dripping Pill was given, 10 pills per time, 3 times a day. Platelet aggregation rate was assessed prior to and after 2-week treatment. Results: Compared with the platelet aggregation rate of AS group, the rates of AR group, ASR group and AR ± ASR group were significantly higher. Among 214 patient of AR or ASR, 103 patients reached the level of AS ( 48.13％ ), 42 patients had the rate dropped by 1/5 but still higher than the AS. Total effective rate equaled to 67.76％, without abnormal findings in hematology, liver function, kidney function. Conclusion: Compound Danshen Dripping Pill can reduce platelet aggregation rate in patients of aspirin resistance, possibly through multi-targeting, which needs further investigation.