Efficacy of different doses of aspirin in decreasing blood levels of inflammatory markers in patients with cardiovascular metabolic syndrome
Efficacy of different doses of aspirin in decreasing blood levels of inflammatory markers in patients with cardiovascular metabolic syndrome
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DOI：
10.1211/jpp/61.11.0010
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发表时间：
2009-11-01
影响因子：
3.3
通讯作者：
Zuo, Zhi-yi
中科院分区：
文献类型：
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作者：
Gao, Xiu-ren;Adhikari, Chandar M.;Zuo, Zhi-yi
目的炎症反应和血小板聚集与活化是心血管事件发生的关键过程。代谢综合征患者发生心血管事件的风险较高。本研究确定是否小剂量和中等剂量的阿司匹林具有抗炎和抗血小板聚集作用的代谢综合征患者，方法121例代谢综合征患者随机分为3组，分别接受阿司匹林100 mg/天，300 mg/天或安慰剂，2周。血栓素B2（TXB 2）是血小板聚集介质TXA 2、6-酮-前列腺素F1-α的稳定产物，（6-酮-PGF 1-α），内源性环氧合酶代谢产物前列腺素I2的稳定产物，以及炎症介质，包括高敏C反应蛋白（hs-CRP）、肿瘤坏死因子-α结果：阿司匹林治疗2周后，hs-CRP、TNF-α、IL-6和TXB 2水平均显著降低，且与对照组相比差异有统计学意义（P < 0. 05）。接受100 mg/天阿司匹林的患者血液中hs-CRP和TXB 2水平降低。治疗2周后，阿司匹林300 mg/d组血IL-6水平明显低于其他两组。阿司匹林在任何剂量没有影响血液中的6-keto-PGF 1-alpha.Conclusions阿司匹林在所有剂量抑制血液中的炎症标志物和血小板聚集介质TXA 2在中国代谢综合征患者的水平。由于300 mg/d阿司匹林诱导的抑制作用大于100 mg/d阿司匹林诱导的抑制作用，这些数据表明，300 mg/d阿司匹林可能有利于降低中国代谢综合征患者的心血管事件风险。
Objectives Inflammation and platelet aggregation and activation are key processes in the initiation of a cardiovascular event. Patients with metabolic syndrome have a high risk of cardiovascular events. This study determined whether small and medium doses of aspirin have anti-inflammation and antiplatelet aggregation effects in patients with metabolic syndrome.Methods One hundred and twenty-one consecutive patients with metabolic syndrome were randomized into three groups, receiving 100 mg/day of aspirin, 300 mg/day of aspirin or a placebo, respectively, for 2 weeks. The blood levels of thromboxane B2 (TXB2), a stable product of the platelet aggregation mediator TXA2, 6-keto-prostaglandin F1-alpha (6-keto-PGF1-alpha), a stable product of the endogenous cyclooxygenase metabolite prostaglandin I2, and inflammatory mediators including high-sensitivity C-reactive protein (hs-CRP), tumour necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6), were determined by ELISA and radioimmunoassay.Key findings The blood levels of hs-CRP, TNF-alpha, IL-6 and TXB2 were significantly decreased after 2 weeks of treatment with 300 mg/day of aspirin. Patients who received 100 mg/day of aspirin had decreased blood levels of hs-CRP and TXB2. The blood level of IL-6 in the 300 mg/day aspirin group was significantly lower than that in the other two groups after 2 weeks of therapy. Aspirin at either dose did not affect the blood level of 6-keto-PGF1-alpha.Conclusions Aspirin at all doses suppresses the blood levels of inflammatory markers and the platelet aggregation mediator TXA2 in Chinese patients with metabolic syndrome. Since the suppression induced by 300 mg/day of aspirin was greater than that induced by 100 mg/day of aspirin, these data suggest that 300 mg/day of aspirin may be beneficial in decreasing the risk of cardiovascular events in Chinese patients with metabolic syndrome.