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目的观察房间隔缺损(atrial septal defect,ASD)、室间隔缺损(ventricular septal defect,VSD)介入封堵术前后血小板聚集的变化并探讨封堵术后服用阿司匹林的合适剂量。方法选择成功进行ASD、VSD介入封堵术的患者各16例,按口服阿司匹林肠溶片的剂量随机分为3mg/kg组和5mg/kg组,分别于术前、术后即刻、术后第4日抽静脉血并测定花生四烯酸(arachidonic acid,AA)、二磷酸腺苷(adenosine diphosphate,ADP)诱导的血小板聚集率。结果①ASD、VSD患者介入封堵术后血小板聚集率明显增加(P<0.01),术后第4日血小板聚集率明显下降(P<0.01);②术后口服阿司匹林3mg/kg组与5mg/kg两组患者介入封堵术后第4日血小板聚集率差异无统计学意义(P>0.05)。结论ASD或VSD封堵术后即刻血小板聚集明显增加,封堵术后第4日血小板聚集明显减弱,口服3mg/kg的阿司匹林抑制血小板聚集疗效类似5mg/kg。
Objective To observe the changes of platelet aggregation before and after atrial septal defect (ASD) and ventricular septal defect (VSD) interventional therapy and to explore the appropriate dose of aspirin after closure. Methods A total of 16 patients with ASD and VSD were included in this study. The dosage of oral aspirin enteric-coated tablets was randomly divided into 3 mg / kg and 5 mg / kg groups. The patients were divided into three groups: preoperative, postoperative, postoperative Venous blood was drawn on day 4 and the platelet aggregation rate induced by arachidonic acid (AA) and adenosine diphosphate (ADP) was measured. Results ① The platelet aggregation rate in patients with ASD and VSD was significantly increased after interventional closure (P <0.01), and the platelet aggregation rate was significantly decreased on the 4th day after operation (P <0.01). ② After aspirin 3mg / kg and 5mg / kg There was no significant difference in platelet aggregation rate between the two groups on the 4th day after interventional closure (P> 0.05). Conclusions ASD or VSD occlusion immediately after platelet aggregation was significantly increased, 4 days after closure of platelet aggregation was significantly reduced, oral administration of 3mg / kg of aspirin platelet aggregation inhibitory effect similar to 5mg / kg.