Research Of Aspirin Resistance Associated Risk Factor Analysis And Danhong Injection Intervention

Aim:The aim of this study was to investigate the risk factors of Aspirin resistance(AR),analyze the mechanism of AR,study the distribution of TCM syndromes in AR and whether drug for invigorating blood circulation and eliminating stasis could reverse AR,provide new method and drug for preventing and treating AR.Methods:Chose 100 coronary artery disease patients who take aspirin(100mg/day)at least 4 weeks with average age of 68.95±8.91 years old.Divided them into three groups according to results of AA induced platelet aggregation test:Platelet aggregation rate ? 80%as AR group(n=12,12%),Platelet aggregation rate ?50%and<80%as Aspirin semiresistance group(ASR)(n=50,50%),Platelet aggregation rate<50%as Aspirin sensitive group(AS)(n=38,38%).Compared the concentration of valley of salicylic acid concentration/TXB2/6-keto-PGF1?,and investigated the symptoms factor distribution rule of these patients,find the relationship between symptoms factor and AR.Then we treated blood stasis patient with Danhong injection,observed the changes of platelet aggregation rate,salicylic acid trough concentration,TXB2 and 6-keto-PGF1?.Results:1.Patients in AR group had a higher risk of cerebrovascular disease(P<0.05),and there was no statistical significance in factors as age,BMI,female and cigarette smoking among AR group,ASR group and AS group(P>0.05).2.There was statistical significance of FBG and 2 h postprandial insulin levels among three groups(P<0.05),and FBG is considered as an independent risk factor of AR through multiple linear regressive analysis.3.The concentration of salicylic acid in AR group was significantly higher than that in AS group(P<0.05),the platelet aggregation rate in AR group and ASR group was significantly higher than that in AS group(P<0.05),which indicates that salicylic acid retention is one of the causes of AR.4.The level of TXB2 in AR group and ASR group was significantly higher than that in AS group(P<0.05),compared with AS group,TXB2/6-keto-PGF1? in AR group increased significantly(P<0.05).5.100 Patients with coronary heart disease were divided into two groups:diabetic group and non-diabetic group,salicylic acid concentration were compared between the two groups,the concentration of salicylic acid in diabetic group was significantly higher than that in non-diabetic group,there was significant difference between the two groups(P<0.05).The result indicated that long-term use of aspirin in patients with coronary heart disease accompanied with diabetes mellitus result in accumulation of salicylic acid,which is one of the causes of AR.6.Distribution of TCM Syndromes:the main solid factor of AR patients are blood stasis(11/91.7%)and Phlegm(9/75%),the main weak factor of AR patients are deficiency of vital energy(7/58.3%)and deficiency of yin(6/50%).Compared with AS group,AR group and ASR group had higher blood stasis syndrome(P<0.05).There is no significant difference in the distribution of the TCM syndromes between the three groups(P>0.05).7.56 patients with blood stasis syndrome were treated with Danhong injection for 7 days,platelet aggregation rate,plasma TXB2 levels and TXB2/6-keto-PGf1? were significantly lower than those before intervention(P<0.05).Salicylic acid trough concentration was decreased and 6-keto-PGf1? level was increased,but there is no significant difference(P>0.05).Conclusion:1.FBG is an independent risk factor for AR,coronary heart disease with diabetes patients with long-term use of aspirin easily lead to accumulation of salicylic acid,which could result in increased platelet aggregation rate;2.Salicylic acid retention is one of the mechanisms of AR,which alters plasma TXB2,6-keto-PGF1? levels and TXB2/6-keto-PGF1? ratio and then results in AR;3.Danhong injection could ameliorate AR by decreasing the level of 6-keto-PGFla,the concentration of salicylic acid,TXB2 and TXB2/6-keto-PGF1?,increasing level of 6-keto-PGFla in blood stasis patients.