허혈성 뇌졸중 환자에서 트리플루잘 투여에 의한 혈소판 응집능 변화

Abstract

Background : Triflusal is a new platelet aggregation inhibitor structurally related to acetylsalicylic acid. We evaluated the inhibitory effects of triflusal on platelet aggregation and tried to determine adequate dosage of triflusal in ischemic stroke patients. Methods : Twenty patients were selected from those who had an ischemic stroke. The daily triflusal dosage was increased by 300 mg every 2 weeks starting from 300 mg/d to 900 mg/d. Platelet aggregation tests were done every 2 weeks during a 6-week period initiating at the beginning of the study. Results : Triflusal inhibited the platelet aggregation induced by epinephrine, collagen, and ADP. Epinephrineinduced platelet aggregation was inhibited most effectively. The percentage of the significant inhibitory responder(> 40% of inhibition) for platelet aggregation induced by epinephrine was increased as the daily dosage was raised: 38% with 300 mg/d, 88% with 600 mg/d, and 100% with 900 mg/d. The difference between 300 mg/d and 600 mg/d was statistically significant(p=.005) but that between 600 mg/d and 900 mg/d was not. The percentage of the significant inhibitory responder for platelet aggregation induced by collagen and ADP was also increased as the daily dosage multiplies. The adverse effects of triflusal(e.g, epigastric soreness and nausea) were observed in 4 of 20 patients(20%) as the dosage increases. Conclusion : Triflusal inhibited the platelet aggregation induced by epinephrine, collagen, and ADP in ischemic stroke patients. These data suggest that the optimal dosage of triflusal for patients with ischemic stroke is 900 mg/d but it can be reduced to 600 mg/d in consideration of the increase of the severe adverse effects at higher dosage. Korean Journal of Stroke 2000;2(2): 186~190