CAJ | 학술논문

目的：探讨以兰索拉唑和雷贝拉唑为代表的质子泵抑制剂（PPI）对氯吡格雷抗血小板作用的影响。方法将67例急性冠脉综合征( ACS )或行经皮冠状动脉介入治疗( PCI )患者随机分为兰索拉唑组（33例）、雷贝拉唑组（34例），按标准治疗方案，均给予氯吡格雷和阿司匹林，分别给予兰索拉唑30 mg／d、雷贝拉唑10 mg／d，给药14 d。以二磷酸腺苷（ADP）诱导血小板聚集，分别测定给予PPI前后最大血小板凝集率（MPA）。结果两组患者平均MPA，PPI治疗前无显著性差异（ P>0.05），给予PPI 14 d后则显著增加（ P<0.05），而两组之间并无显著性差异（ P>0.05）。结论兰索拉唑与雷贝拉唑可在一定程度上干扰氯吡格雷的抗血小板作用，且干扰程度大致相当。
목적：탐토이란색랍서화뢰패랍서위대표적질자빙억제제（PPI）대록필격뢰항혈소판작용적영향。방법장67례급성관맥종합정( ACS )혹행경피관상동맥개입치료( PCI )환자수궤분위란색랍서조（33례）、뢰패랍서조（34례），안표준치료방안，균급여록필격뢰화아사필림，분별급여란색랍서30 mg／d、뢰패랍서10 mg／d，급약14 d。이이린산선감（ADP）유도혈소판취집，분별측정급여PPI전후최대혈소판응집솔（MPA）。결과량조환자평균MPA，PPI치료전무현저성차이（ P>0.05），급여PPI 14 d후칙현저증가（ P<0.05），이량조지간병무현저성차이（ P>0.05）。결론란색랍서여뢰패랍서가재일정정도상간우록필격뢰적항혈소판작용，차간우정도대치상당。
Objective To investigate tbe influence of lansoprazole and rabeprazole as representative of proton pump inbibitor(PPI) on antiplatelet effect of clopidgrel. Methods Totally 67 patients witb acute coronary syndrome(ACS) or undergoing elective percutaneous coronary intervention(PCI)were enrolled and randomly divided into tbe lansoprazole group( n=33)and tbe rabeprazole group( n=34). Tbe two groups were given clopidogrel and aspirin according to tbe standard tberapeutical regimen. Lansoprazole 30 mg/d and rabepra-zole 10 mg/d were respectively given for 14 d. Adenosine 5-dipbospbate(ADP) was used to induce platelet aggregation. Tbe maximal platelet aggregation(MPA) rate before and after PPI treatment were measured in tbe two groups. Results Tbe mean MPA rate before PPI treatment bad no statistically significant difference between tbe two groups( P > 0. 05),but after 14 d PPI treatment in botb groups it was significantly increased( P < 0. 05),wbile tbe difference between tbe two groups bad no statistical significance( P > 0. 05). Conclusion Botb lansoprazole and rabeprazole interfere in tbe antiplatelet effect of clopidogrel to some extent and tbe interference de-gree of tbe two is approximately tbe same.