中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2010年
4期
37-38,41
,共3页
王卫平%邱春光%韩战营%邱承杰%孙彦彦%卢文杰%杨长宝%陈晓杰
王衛平%邱春光%韓戰營%邱承傑%孫彥彥%盧文傑%楊長寶%陳曉傑
왕위평%구춘광%한전영%구승걸%손언언%로문걸%양장보%진효걸
埃索美拉唑%泮托拉唑%氯吡格雷%血小板聚集率%相互作用
埃索美拉唑%泮託拉唑%氯吡格雷%血小闆聚集率%相互作用
애색미랍서%반탁랍서%록필격뢰%혈소판취집솔%상호작용
Esomeprazole%Pantoprazole%Clopidogrel%Platelet aggregation rate%Interaction
目的 检测联合应用氯吡格雷与质子泵抑制剂前后的血小板聚集率,通过比较用药前后的的血小板聚集率的差值,探讨埃索美拉唑、泮托拉唑是否会影响氯吡格雷的抗血小板作用.方法 入选200例急性冠状动脉综合征患者,均给予双重抗血小板聚集治疗(阿司匹林肠溶片100 mg/d,氯吡格雷负荷量300 mg后75 mg/d维持),分为埃索美拉唑组(埃索美拉唑20 mg/d)60例,泮托拉唑组(泮托拉唑40 mg/d)60例及不合用质子泵抑制剂的对照组80例.于用药前及用药后7 d应用比浊法测定ADP诱导的血小板最大聚集率及住院期间、1个月内的主要心血管事件,比较三组间血小板聚集率前后差值及主要心血管事件(非致命性心肌梗死,非致命性卒中和死于心血管疾病)发生率差异有无统计学意义.结果 三组间血小板聚集率的差值在对照组(26.7±3.3)%、埃索美拉唑组(26.5±3.6)%、泮托拉唑组(25.6±2.9)%差异无统计学意义(P＞0.05),主要心血管事件发生率差异无统计学意义(P＞0.05).结论 泮托拉唑、埃索美拉唑不影响氯吡格雷的抗血小板聚集作用.
目的 檢測聯閤應用氯吡格雷與質子泵抑製劑前後的血小闆聚集率,通過比較用藥前後的的血小闆聚集率的差值,探討埃索美拉唑、泮託拉唑是否會影響氯吡格雷的抗血小闆作用.方法 入選200例急性冠狀動脈綜閤徵患者,均給予雙重抗血小闆聚集治療(阿司匹林腸溶片100 mg/d,氯吡格雷負荷量300 mg後75 mg/d維持),分為埃索美拉唑組(埃索美拉唑20 mg/d)60例,泮託拉唑組(泮託拉唑40 mg/d)60例及不閤用質子泵抑製劑的對照組80例.于用藥前及用藥後7 d應用比濁法測定ADP誘導的血小闆最大聚集率及住院期間、1箇月內的主要心血管事件,比較三組間血小闆聚集率前後差值及主要心血管事件(非緻命性心肌梗死,非緻命性卒中和死于心血管疾病)髮生率差異有無統計學意義.結果 三組間血小闆聚集率的差值在對照組(26.7±3.3)%、埃索美拉唑組(26.5±3.6)%、泮託拉唑組(25.6±2.9)%差異無統計學意義(P＞0.05),主要心血管事件髮生率差異無統計學意義(P＞0.05).結論 泮託拉唑、埃索美拉唑不影響氯吡格雷的抗血小闆聚集作用.
목적 검측연합응용록필격뢰여질자빙억제제전후적혈소판취집솔,통과비교용약전후적적혈소판취집솔적차치,탐토애색미랍서、반탁랍서시부회영향록필격뢰적항혈소판작용.방법 입선200례급성관상동맥종합정환자,균급여쌍중항혈소판취집치료(아사필림장용편100 mg/d,록필격뢰부하량300 mg후75 mg/d유지),분위애색미랍서조(애색미랍서20 mg/d)60례,반탁랍서조(반탁랍서40 mg/d)60례급불합용질자빙억제제적대조조80례.우용약전급용약후7 d응용비탁법측정ADP유도적혈소판최대취집솔급주원기간、1개월내적주요심혈관사건,비교삼조간혈소판취집솔전후차치급주요심혈관사건(비치명성심기경사,비치명성졸중화사우심혈관질병)발생솔차이유무통계학의의.결과 삼조간혈소판취집솔적차치재대조조(26.7±3.3)%、애색미랍서조(26.5±3.6)%、반탁랍서조(25.6±2.9)%차이무통계학의의(P＞0.05),주요심혈관사건발생솔차이무통계학의의(P＞0.05).결론 반탁랍서、애색미랍서불영향록필격뢰적항혈소판취집작용.
Objective To determine the platelet aggregation rates before and after the usage of clopidogrel in combination with proton pump inhibitors and compare the differences of the rates of platelet aggregation in order to explore whether esomeprazole, pantoprazole will affect the anti-platelet aggregation effect of clopidogrel. Methods Two hundred patients with acute coronary syndrome were treated with dual antiplatelet aggregation therapy ( aspirin enteric - coated tablets 75 mg/d, clopidogrel after 300 mg loading dose 75 mg/d maintenance), and were divided into three groups: esomeprazole group (Esomeprazole 20 mg/d) 60 cases, pantoprazole group (Pantoprazole 40 mg/d) 60 cases and control group ( without proton pump inhibitors) 80 cases. The ADP - induced maximum platelet aggregation rates were detected by Turbidimetry on the day before and 7 days after the medication. The differences of the rate of platelet aggregation in the three groups before and after the medication and the incidence of major cardiovascular events were recorded. Results There was no significant difference in the platelet aggregation rate of the three groups,which were (26.7 ± 3.3) % in the control group, (26.5 ± 3.6) % in the esomeprazole group and (25.6 ± 2.9 ) % in the pantoprazole group. Conclusions Pantoprazole and esomeprazole do not affect the anti-platelet aggregation effect of clopidogrel.
