Bibliography:
[1] Qiao Fuqu. Introduction to Japanese Medicine,1980,(04):3.
[2] 小剂量阿司匹林能较好地Prevention thrombosis [J].国外医学情报,1980,(12):217.
[3] Cai Huaining. New Medicine,1981,(09):504.
There are data that the mortality rate of myocardial infarction is about 20%, while the mortality rate of cerebral infarction is about 10%. And with the improvement of quality of life, the incidence of myocardial infarction and cerebral infarction is also increasing year by year. In this regard, there are also many drugs on the market to prevent myocardial infarction and cerebral infarction, such as anti-atherosclerosis drugs, the most common is aspirin. But how effective exactly is aspirin?
In 2020, Jiang Dahai is 45 years old and runs a small store, often holding his beer belly to drink and chat with friends. In May, Jiang Dahai's son dragged him and his wife to the hospital for a physical examination, and it was found that Jiang Dahai's blood lipids were very high. The blood lipid test showed that triglycerides were 2.1 mmol/L; HDL cholesterol level: 0.95mmol/L; The appropriate level of LDL cholesterol was 3.39 mmol/L.
The doctor reminded Jiang Dahai that he must control his blood lipids well from now on, otherwise it is easy to produce blood clots, which will lead to cerebral infarction or myocardial infarction. Jiang Dahai unconsciously clenched his hands tightly, his mouth pursed into a straight line, his son was still communicating with the doctor, but Jiang Dahai thought of Lao Li, who had a cerebral infarction next door he saw last year, he could only be paralyzed in bed every day, and left a few days after returning home after being diagnosed.
Jiang Dahai still felt scared after returning home, so he began to inquire everywhere, ways to prevent cerebral infarction and myocardial infarction, on June 5, Jiang Dahai wanted to play chess in the park as usual, and heard a chess friend say that he had a cerebral infarction 5 years ago, and he has been taking aspirin since he was cured, and he has not relapsed. Hearing this, Jiang Dahai also decided to take aspirin to prevent it.
On the morning of the 6th in 2020, when Jiang Dahai was restocking, he had a sharp pain in his stomach, nausea and vomiting, his head was also dizzy, and his body seemed to be pressed by some heavy object.
At noon for lunch, Jiang Dahai looked at a table of dishes and had no appetite at all, at this time he was about to get up and go back to the room, after standing up, he suddenly felt that a thread in his head seemed to be broken, and his body began to fall to the ground involuntarily, Jiang Dahai wanted to reach out to the dining table next to him, but he had no strength to reach out at all, he fell to the ground like this, and his wife saw it and quickly helped him up and took him to the hospital.
When he arrived at the hospital, the doctor found that Jiang Dahai's face was pale, so he hurriedly arranged a blood test, and the results showed that hemoglobin was 100g/L; The mean volume of red blood cells is 65FL; The mean hemoglobin concentration of red blood cells is 25%. positive for fecal occult blood. The doctor judged that Jiang Dahai was mildly anemic. Mild anemia is caused by a decrease in the number of red blood cells and the amount of hemoglobin in the blood. In life, you can increase nutrition, eat more foods containing high protein and vitamins, and you can also properly tonify angelica stewed hens, angelica rabbit broth or ejiao glutinous rice porridge.
When he was discharged from the hospital, the doctor instructed Jiang Dahai: "After returning home, you must supplement your nutrition well, if you have long-term anemia, and your blood lipids are very high, the blood flow is very slow, which can easily cause insufficient blood supply, which will lead to cerebral infarction!" Jiang Dahai remembered the doctor's words, and at the same time strengthened his determination to take aspirin all the time.
In 2023, Jiang Dahai has been taking aspirin for nearly 22 years, and on October 15, Jiang Dahai stood as usual and watched others play chess, inexplicably feeling back pain, as if he couldn't stand steadily, his heartbeat was getting faster and faster, and he would have tinnitus from time to time. He hurriedly found a place to sit down and rest, and after a while, his body was much better, so Jiang Dahai did not pay attention to the discomfort this time.
In February 2024, Jiang Dahai found that his skin was getting more and more yellow when he was taking a bath, and the whites of his eyes were also dyed a faint yellow. But he didn't take the matter to heart. In April 2024, Jiang Dahai hugged his granddaughter to sleep, he carefully put his granddaughter on the bed, straightened his waist, only felt a white light flashed in his head, and only a buzzing sound was left in his ears, and with a "bang", Jiang Dahai's body fell. The wife who heard the sound entered the room to check, and then hurriedly sent Jiang Dahai to the hospital.
After coming to the hospital, the doctor saw that Jiang Dahai's skin and sclera were yellow, and the physical examination found that the spleen could be palpated under the ribs, and the red blood cell count was 80g/L after further monitoring of the blood routine, and the peripheral blood smear showed fragmented and malformed red blood cells, and nucleated red blood cells could be seen. Blood free bilirubin 40.5 μmol/L, urine bilirubin negative. The doctor judged that Jiang Dahai may have hemolytic anemia.
First of all, hemolysis refers to the pathological condition in which red blood cells rupture, dissolve, and hemoglobin escapes from red blood cells due to various reasons. Hemolytic anemia simply refers to anemia that occurs due to various reasons that cause the rupture and dissolution of red blood cells beyond the rate of bone marrow hematopoiesis. Hemolytic anemia accounts for about 5% of total anemia. It is generally divided into acute hemolysis and chronic hemolysis, acute is mostly intravascular hemolysis, and chronic is mostly extravascular hemolysis.
The doctor thought it was very strange, why did Jiang Dahai, who was only mildly anemic four years ago, develop hemolytic anemia now? He asked Jiang Dahai if he had taken any special medicine, Jiang Dahai patted his head and thought, "No!" I just took lipid-lowering drugs and aspirin! The doctor heard aspirin and hurriedly asked, "Aspirin?" How long have you been eating? ”
Jiang Dahai crossed his fingers and said slowly: "It's been 22 years, and I take aspirin every day to prevent heart attack and cerebral infarction. The doctor was surprised and frightened: "You can't take aspirin with your physical condition!" You made 3 very serious mistakes in the process of taking medicine, and taking aspirin according to your way is equivalent to chronic suicide! ”
1. Aspirin is an antipyretic analgesic, a derivative of salicylic acid, which can be used to relieve mild or moderate pain, in addition, it has an inhibitory effect on platelet aggregation, and can be used to prevent cerebral infarction and myocardial infarction or the formation of thrombosis after surgery. Aspirin is often used in conjunction with atorvastatin calcium tablets to prevent cerebral infarction caused by high-risk factors. It can also be used in conjunction with anticoagulant drugs and some hypoglycemic drugs to enhance their efficacy.
2. Patients with a history of gastric ulcer are prohibited. Aspirin directly irritates the gastric mucosa, causing the gastric mucosa to rupture. Aspirin can also promote gastric acid secretion to further damage the gastric mucosa, while the gastric mucosa inhibits the production of prostaglandins, thereby weakening the gastric mucosal defense mechanism, resulting in gastric bleeding. Alcohol should also be avoided while taking aspirin, which increases the risk of stomach bleeding.
3. When symptoms such as melena and hematemesis appear, aspirin should be stopped immediately. Melena is generally caused by upper gastrointestinal bleeding, and when the amount of bleeding exceeds 60ml, oily stools can be seen. This is a sign that there may be bleeding in the body. In this case, it is necessary to stop aspirin immediately to prevent repeated irritation of the gastric mucosa by aspirin and causing gastric bleeding.
4. Aspirin may cause hemolytic anemia. The oxidation of aspirin, when the reduced glutathione in red blood cells is insufficient, it will be difficult to resist the oxidation of aspirin, and then the red blood cell membrane will be oxidized and hemolytic phenomenon. To put it simply, some people's red blood cells have their own defects, which make it difficult to resist the damage of aspirin to red blood cells, resulting in red blood cell rupture. Therefore, it is important to take the medication under the correct advice and guidance of the doctor.