Mankhwala Oteteza Aspirin

Aspirin, monga mankhwala othandiza polimbana ndi kusonkhana kwa ma platelet, imagwiritsidwa ntchito kwambiri popewa ndi kuchiza matenda a mtima ndi mitsempha yamagazi. Kafukufukuyu adapeza kuti odwala ena apezeka kuti sangathe kuletsa bwino ntchito ya ma platelet ngakhale atagwiritsa ntchito aspirin kwa nthawi yayitali, kutanthauza kukana kwa aspirin (AR). Chiŵerengerochi ndi pafupifupi 50%-60%, ndipo pali kusiyana koonekeratu kwa mitundu. Glycoprotein IIb/IIIa (GPI IIb/IIIa) imagwira ntchito yofunika kwambiri pakusonkhana kwa ma platelet ndi thrombosis pamalo omwe mitsempha yamagazi yavulala. Kafukufuku wasonyeza kuti ma gene polymorphisms amagwira ntchito yofunika kwambiri pakukana aspirin, makamaka kuyang'ana kwambiri ma gene polymorphisms a GPIIIa P1A1/A2, PEAR1 ndi PTGS1. GPIIIa P1A2 ndiye jini yayikulu yotsutsana ndi aspirin. Kusintha kwa majini kumeneku kumasintha kapangidwe ka ma receptor a GPIIb/IIIa, zomwe zimapangitsa kuti pakhale kulumikizana pakati pa ma platelet ndi kusonkhana kwa ma platelet. Kafukufukuyu adapeza kuti kuchuluka kwa ma alele a P1A2 mwa odwala omwe salandira aspirin kunali kwakukulu kwambiri kuposa kwa odwala omwe ali ndi vuto la aspirin, ndipo odwala omwe ali ndi kusintha kwa P1A2/A2 anali ndi vuto lochepa atamwa aspirin. Odwala omwe ali ndi ma alele a P1A2 omwe amalandira stenting amakhala ndi vuto la subacute thrombotic event lomwe ndi kuwirikiza kasanu kuposa odwala a P1A1 homozygous wild-type, omwe amafunikira aspirin yambiri kuti akwaniritse zotsatira zoletsa magazi kuundana. Allele ya PEAR1 GG imayankha bwino aspirin, ndipo odwala omwe ali ndi genotype ya AA kapena AG omwe amamwa aspirin (kapena kuphatikiza ndi clopidogrel) atapatsidwa stent amakhala ndi infarction yayikulu ya myocardial ndi imfa. Genotype ya PTGS1 GG ili ndi chiopsezo chachikulu cha kukana aspirin (HR: 10) komanso kuchuluka kwa zochitika zamtima (HR: 2.55). Genotype ya AG ili ndi chiopsezo chochepa, ndipo chisamaliro chapadera chiyenera kuperekedwa ku zotsatira za chithandizo cha aspirin. Genotype ya AA imakhudzidwa kwambiri ndi aspirin, ndipo kuchuluka kwa zochitika zamtima ndi kochepa. Zotsatira zodziwira za mankhwalawa zimangoyimira zotsatira zodziwira majini a PEAR1, PTGS1, ndi GPIIIa a anthu.