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阿司匹林抵抗是一个重要的临床问题。研究表明,一些非甾体抗炎药,如布洛芬、吲哚美辛等均可以拮抗阿司匹林对血小板COX-1的抑制作用,导致阿司匹林抵抗。这种非甾体抗炎药-阿司匹林相互作用使得关节炎患者难以使用阿司匹林来预防心血管疾病的发作。在本次实验中,我们在体内、外分别研究了咖啡酸对布洛芬、吲哚美辛和阿司匹林之间相互作用的影响。布洛芬和吲哚美辛对花生四烯酸诱导的血小板聚集均具有弱的抑制作用,同时它们均可以显著抑制阿司匹林的抗血小板聚集活性,但是,它们对咖啡酸的抗血小板聚集活性无明显影响。有趣的是,当咖啡酸和布洛芬以及吲哚美辛同时使用时,可以消除它们对阿司匹林活性的拮抗作用,提示咖啡酸可以逆转布洛芬、吲哚美辛和阿司匹林之间相互作用。体内实验也得到类似的结果。综上所述,我们的实验结果提示,伴有关节炎的心血管疾病患者使用阿司匹林时,补充咖啡酸可以降低非甾体抗炎药对阿司匹林活性的拮抗作用,有利于疾病的治疗。
Aspirin resistance is an important clinical problem. Studies have shown that some non-steroidal anti-inflammatory drugs, such as ibuprofen, indomethacin and so on, can antagonize aspirin on platelet COX-1 inhibition, leading to aspirin resistance. This non-steroidal anti-inflammatory drug-aspirin interaction makes arthritis patients difficult to use aspirin to prevent the onset of cardiovascular disease. In this experiment, we investigated the effect of caffeic acid on the interaction between ibuprofen, indomethacin and aspirin in vitro and in vivo. Both ibuprofen and indomethacin had a weak inhibitory effect on arachidonic acid-induced platelet aggregation, and both of them could significantly inhibit aspirin’s anti-platelet aggregation activity, however, they showed no obvious anti-platelet aggregation activity on caffeic acid influences. Interestingly, when caffeic acid is used in combination with ibuprofen and indomethacin, their antagonism of aspirin activity can be eliminated, suggesting that caffeic acid can reverse the interaction between ibuprofen, indomethacin and aspirin. In vivo experiments also yielded similar results. Taken together, our results suggest that aspirin supplementation with caffeic acid may reduce the antagonistic effect of NSAIDs on aspirin activity in the treatment of cardiovascular disease patients with arthritis.