CAJ | 학술논문

目的：探讨国产与进口的阿司匹林和氯吡格雷对冠心病心绞痛患者的血小板聚集率(MPA)、血小板反应指数(PRI)及安全性的影响。方法回顾性分析2012年11月~2013年11月因冠心病心绞痛入我院接受治疗的100例患者临床资料，根据用药来源不同分为进口组和国产组各50例。进口组采用进口的阿司匹林和氯吡格雷进行治疗；国产组采用国产的阿司匹林联用氯吡格雷治疗。比较两组患者用药前、用药1、2周后和停药6、12 h及1 d后的MPA、PRI，并观察治疗1年内心血管和药物不良反应发生情况。结果两组治疗前MPA、PRI差异均无显著统计学意义(P>0.05)；在治疗后1、2周，进口组MPA、PRI均低于国产组，差异具有统计学意义(P<0.05)。停药后6 h，两组患者MPA无差异(t=1.209，P=0.229>0.05)，停药12 h及1 d后，进口组MPA均高于国产组(P<0.05)；停药6 h、12 h后，国产组PRI均显著高于进口组(P<0.05)，停药1 d后则无统计学意义(t=1.332，P=0.186>0.05)。进口组心血管不良事件发生率均低于国产组，差异均有统计学意义(P<0.05)。进口组皮疹、腹痛、挫伤发生率均低于国产组，差异均有统计学意义(P<0.05)。结论与国产药品对比，进口的阿司匹林和氯吡格雷对冠心病心绞痛患者抗血小板凝血起到积极有效作用，且停药后血小板作用可迅速恢复，可显著降低心肌梗死、心绞痛等复发，预防心脑血管意外，降低患者死亡率。
목적：탐토국산여진구적아사필림화록필격뢰대관심병심교통환자적혈소판취집솔(MPA)、혈소판반응지수(PRI)급안전성적영향。방법회고성분석2012년11월~2013년11월인관심병심교통입아원접수치료적100례환자림상자료，근거용약래원불동분위진구조화국산조각50례。진구조채용진구적아사필림화록필격뢰진행치료；국산조채용국산적아사필림련용록필격뢰치료。비교량조환자용약전、용약1、2주후화정약6、12 h급1 d후적MPA、PRI，병관찰치료1년내심혈관화약물불량반응발생정황。결과량조치료전MPA、PRI차이균무현저통계학의의(P>0.05)；재치료후1、2주，진구조MPA、PRI균저우국산조，차이구유통계학의의(P<0.05)。정약후6 h，량조환자MPA무차이(t=1.209，P=0.229>0.05)，정약12 h급1 d후，진구조MPA균고우국산조(P<0.05)；정약6 h、12 h후，국산조PRI균현저고우진구조(P<0.05)，정약1 d후칙무통계학의의(t=1.332，P=0.186>0.05)。진구조심혈관불량사건발생솔균저우국산조，차이균유통계학의의(P<0.05)。진구조피진、복통、좌상발생솔균저우국산조，차이균유통계학의의(P<0.05)。결론여국산약품대비，진구적아사필림화록필격뢰대관심병심교통환자항혈소판응혈기도적겁유효작용，차정약후혈소판작용가신속회복，가현저강저심기경사、심교통등복발，예방심뇌혈관의외，강저환자사망솔。
Objective To explore the influence of platelet aggregation rate, platelet response index in patients with coronary heart disease by domestic and imported aspirin and clopidogrel and its safety. Methods The date of 100 cases patients with coronary heart disease for angina pectoris from November 2012 to November 2013 were retrospectively analyzed in this study, according to different drug sources, they were divided into import group and domestic group, 50 cases each. Import group was treated with imported aspirin and clopidogrel, the domestic group was treated with domestic aspirin and clopidogrel. MPA, PRI before medication, medication discontinuation after 1, 2 weeks and 6 h, 12 h and 1 d after discontinuation between two groups were compared, treatment of cardiovascular and adverse drug reactions occur within 1 year were observed. Results There was no significant difference between two groups for MPA and PRI before treatment (P>0.05); MPA, PRI after treatment 1 week, 2 weeks in import group were lower than that in domestic group (P<0.05). 6 h after the drug was stopped, MPA had no difference between two groups (t=1.209, P=0.229>0.05), 12 h and 1 d after drug withdrawal, MPA in import group were higher than that in domestic group ( P<0 . 05 ); Discontinuation after 6 h , 12 h , PRI in domestic group were significantly higher than that in import group (P<0.05), after the withdrawal of 1 d, there was no statistical significance (t=1.332, P=0.186>0.05). The incidence of cardiovascular adverse events in import group were lower than that in the domestic group, with statistically significant differences (P<0.05). Team rash, abdominal pain, bruising rates in import group were lower than that in domestic group, the differences were statistically significant (P<0.05). Conclusion Compared with domestic, aspirin combined with clopidogrel plays a positive and effective role in resistting platelet clotting in patients with coronary heart disease for angina pectoris, and platelet function can be quickly restored after the drug is stopped, can significantly reduce the recurrence of myocardial infarction, angina pectoris, heart cerebrovascular accident prevention, reduce mortality.