瑞舒伐他汀和阿托伐他汀在急性冠脉综合症中对氯吡格雷抗血小板活性的对比研究

被引：13

作者：

高晗 ^{[1
]}

赵侃 ^{[2
]}

尹雪松 ^{[2
]}

彭成海 ^{[2
]}

任仲桥 ^{[2
]}

张吉红 ^{[2
]}

机构：

[1] 哈尔滨医科大学

[2] 哈尔滨医科大学附属第四医院急诊科

来源：

现代生物医学进展 | 2014年 / 14卷 / 04期

关键词：

急性冠脉综合症; 细胞色素P450; 氯吡格雷; 瑞舒伐他汀; 阿托伐他汀; 血小板活性;

D O I：

10.13241/j.cnki.pmb.2014.04.023

中图分类号：

R541.4 [冠状动脉（粥样）硬化性心脏病（冠心病）];

学科分类号：

1002 ; 100201 ;

摘要：

目的:在急性冠脉综合征(acute coronary syndromes,ACS)的治疗中,抗血小板治疗及调脂治疗是最基础的治疗方案。近来有学者提出,氯吡格雷和他汀类药物都经过细胞色素CYP 3A4途径代谢,二者因存在竞争性抑制,有可能降低氯吡格雷抗血小板的活性。本试验将针对阿托伐他汀及瑞舒伐他汀进行研究。方法:选择急性冠脉综合症的患者42例,所有患者均接受氯吡格雷治疗(负荷剂量300 mg,维持剂量75 mg/d)。随机分配为A、B两组,A组(n=20)服用阿托伐他汀治疗(20 mg/d),B组(n=22服用瑞舒伐他汀治疗(10 mg/d)。分别于氯吡格雷服用前、服药治疗后3天、服药治疗后7天后采静脉血送检,测定ADP(10μmol/L)诱导的血小板聚集率。结果:阿托伐他汀组(A组)及瑞舒伐他汀组(B组)相比,服用氯吡格雷前ADP诱导的血小板聚集率基线值无统计学差异。服用氯吡格雷3日及7日后,ADP诱导的血小板聚集率明显降低,(3.85±2.58)vs(3.09±2.27),(0.65±0.88)vs(1.05±0.95),P>0.05,无明显统计学差异。结论:氯吡格雷的确可以降低血小板的活性。同时,短期之内氯吡格雷的抗血小板活性未受到他汀类的影响,包括经过CPY3A4途径的他汀,如阿托伐他汀。

引用

页码：697 / 699+703 +703

页数：4

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