阿司匹林联合氯吡格雷治疗进展性缺血性脑卒中的疗效及对hs-CRP水平的影响

目的探讨阿司匹林联合氯吡格雷治疗进展性缺血性脑卒中的疗效及对高敏C反应蛋白(hs-CRP)水平的影响。方法将108例进展性缺血性脑卒中患者,按随机数字表法分成观察组和对照组,每组各54例。观察组采用阿司匹林联合氯吡格雷治疗;对照组单用阿司匹林治疗,疗程均为15 d。治疗前后检测临床神经缺损程度及血清hs-CRP水平,并观察治疗后临床疗效及不良反应。结果两组神经功能缺损程度评分及血清hs-CRP水平比较,差异有统计学意义(P<0.05);时间对神经功能缺损程度评分和血清hs-CRP水平有影响(P<0.05),治疗方法与时间之间无明显交互作用(P>0.05);观察组疗效、总有效率均优于对照组(P<0.05)。两组不良反应发生情况,差异无统计学意义(P>0.05)。结论阿司匹林联合氯吡格雷治疗进展性缺血性脑卒中患者的神经功能恢复及疗效均优于单用阿司匹林,且血清hs-CRP水平也显著降低。     

氯吡格雷联合阿司匹林在短暂性脑缺血发作中的疗效及安全性研究

目的探讨氯吡格雷联合阿司匹林用于短暂性脑缺血发作患者的临床疗效及安全性。方法选取2009年1月～2010年3月在我院住院治疗的124例短暂性脑缺血发作患者,作为研究对象,将所有患者按照随机分组原则分为对照组和观察组,两组患者均予以改善脑循环的常规药物治疗。对照组患者采用阿司匹林治疗,观察组患者在对照组患者治疗基础上,加用氯吡格雷治疗。1年后,比较两组患者的疗效及药物不良反应情况,综合评价氯吡格雷联合阿司匹林治疗短暂性脑缺血发作患者的临床效果。结果两组患者的临床总有效率、脑卒中的发生比率比较,观察组明显好于对照组,P值均<0.05,均具有统计学意义。两组患者药物不良反应反馈主要是胃肠道不适,病例数和严重程度均无显著性差异,停药后自行消失。结论氯吡格雷联合阿司匹林治疗短暂性脑缺血发作患者疗效确切,无严重不良反应,是治疗该疾病安全有效的药物。     

阿司匹林和氯吡格雷药物抵抗的研究进展

资料显示,以阿司匹林、氯吡格雷为基础的抗血小板治疗,能显著降低心血管不良事件发生的风险。然而,不同的个体对于抗血小板药物的反应性不同。文献[2,3]报道,5%～45%服用阿司匹林的患者及4%～30%服用氯吡格雷的患者不能达到理想的抗血小板作用。Lev等报道,阿司匹林抵抗者常可伴发氯吡格雷抵抗,因而这类患者在经皮冠脉介入术后发生血栓栓塞事件的危险性增加。阿司匹林抵抗及氯吡格雷抵抗的概念是类似的,一些学者称之为抗血小板药物抵抗,又分为临床抗血小     

氯吡格雷联合阿司匹林治疗老年心肌梗死合并糖尿病的疗效分析

目的探究氯吡格雷联合阿司匹林治疗老年心肌梗死合并糖尿病的临床疗效。方法选自收治的86例老年心肌梗死合并糖尿病患者,按照入院顺序单双号随机分为实验组与参照组,每组43例。参照组患者给予口服阿司匹林、降糖、溶栓等综合疗法,实验组患者在参照组患者的治疗基础上加用氯吡格雷进行治疗。观察两组患者的血糖改善情况、血管再通情况以及不良反应发生情况。结果实验组患者的血管再通率明显高于参照组,P<0.05;两组患者的血糖改善程度比较差异不显著,P>0.05;实验组患者的不良反应发生率低于参照组,P<0.05。结论应用氯吡格雷联合阿司匹林治疗老年心肌梗死合并糖尿病效果显著,且不良反应少,具有较高的临床价值。     

阿司匹林抵抗与缺血性脑卒中复发相关性研究

目的应用血栓弹力图预测阿司匹林抵抗情况,探讨阿司匹林抵抗与缺血性脑卒中复发的相关性。方法选取2013年6月至2015年6月收治的376例缺血性脑卒中患者,根据阿司匹林用药7~10 d后的血栓弹力图结果,将患者分为阿司匹林抵抗(AR)组62例与阿司匹林敏感(AS)组314例。随访4~12个月,记录缺血性脑卒中复发与并发症发生例数,采用Logistic多因素回归分析阿司匹林抵抗与缺血性脑卒中复发的相关性。结果缺血性脑卒中复发患者为58例,无复发318例。缺血性脑卒中复发患者的平均年龄、糖尿病比例、抗血小板药物依从性差比例、AR比例、美国国立卫生研究所卒中量表(NHISS)评分、低密度脂蛋白明显低于无复发患者,两组比较,差异有统计学意义(P<0.05)。AS组患者缺血性脑卒中复发率为7.00%(22/314),脑出血发生率为2.23%(7/314),心肌梗死发生率为1.27%(4/314),其他并发症发生率为1.27%(4/314);AR组患者则分别为32.26%(20/62),6.45%(4/62),4.84%(3/62),3.22%(2/62)。两组比较,缺血性脑卒中复发率差异有统计学意义(P<0.05),其余差异均无统计学意义(P>0.05)。Logistic多因素回归分析中,平均年龄、糖尿病、抗血小板药物依从性差、AR是缺血性脑卒中复发的独立危险因素(P<0.05),其中,AR与缺血性脑卒中复发呈正相关(比值比=4.758,95%可信区间1.519~13.686,P<0.05)。结论阿司匹林抵抗与缺血性脑卒中复发存在明显正相关,可增加心脑血管事件复发率。     

拜阿司匹林联合氯吡格雷及地尔硫卓治疗CAE疗效观察

目的 探讨拜阿司匹林联合氯吡格雷和地尔硫卓治疗冠状动脉扩张的临床疗效。方法 选取我院2012年1月~2014年7月收治的冠状动脉扩张患者188例,随机分为研究组和对照组,对照组在积极治疗原发疾病和抗心绞痛治疗的基础上,联合应用拜阿司匹林和氯吡格雷治疗,研究组在对照组治疗基础上加用地尔硫卓治疗,并比较两组疗效。结果 研究组心绞痛治疗总有效率为88.8%,心电图改善总有效率为82.7%,均明显大于对照组(67.8%,56.7%,P<0.05);两组均未见明显不良反应发生。结论 拜阿司匹林、氯吡格雷、地尔硫卓3种药物联合应用治疗冠状动脉扩张可明显提高疗效,且安全性高,值得临床推广应用。     

外周动脉介入治疗伴单联或双联抗血小板疗法的镜像研究:随机双盲临床实验

目的探讨双联抗血小板疗法与单独应用阿司匹林对外周动脉疾病血管内治疗的病人局部血小板活化与临床终点的影响。方法病人于介入前服用500mg或300mg氯吡格雷,介入后每日服用阿司匹林100mg和氯吡格雷75mg或相同剂量的阿司匹林与安慰剂(氯吡格雷替代品),为期6个月。主要终点是血小板活化标记物β-血小板球蛋白和CD40L的局部浓度,以及病人对氯吡格雷的抗药率。次要终点包括介入后6个月的临床进展。结果入组病人80例,两组各40例。氯吡格雷组和安慰剂组β-血小板球蛋白平均介入周围浓度分别为224.5与365.5(P=0.03),CD40L的浓度分别为127和206.5(P=0.05)。30%接受氯吡格雷的病人具有抗药性。2例氯吡格雷组和8例安慰剂组病人需目标病灶血运重建(P=0.04)。需血运重建的氯吡格雷组病人对氯吡格雷均具抗药性。1例氯吡格雷组和2例安慰剂组病人并发轻微出血。结论双联抗血小板疗法可减少介入周围血小板活化,并可改善其功能而未并发大量出血。个体化双联抗血小板疗法对于外周动脉疾病病人的血管内治疗效果较满意。要点①探讨血管内治疗后氯吡格雷和阿司匹林的作用。②相比单纯应用阿司匹林,双联抗血小板疗法可减少介入周围血小板活化。③双联抗血小板疗法可改善血管内治疗病人的疗效。④当治疗血管内外周动脉疾病时,氯吡格雷抗药性很重要。     

负荷量双抗血小板联合低分子肝素治疗频发短暂性脑缺血发作的短期疗效

 目的 观察负荷量阿司匹林、氯吡格雷联合低分子肝素治疗短暂性脑缺血发作(aransient ischemic attack ,TIA)的临床疗效及安全性。方法 96例TIA患者随机分为对照组和观察组。对照组使用单剂量阿司匹林和氯吡格雷,观察组用负荷量阿司匹林、氯吡格雷联合腹壁皮下注射低分子肝素,治疗1周时进行两组临床疗效评价。结果 观察组的总有效率为91.67%,高于对照组的70.83%(P<0.01)。两组脑出血、消化道出血、牙龈出血、皮肤黏膜出血等不良反应差异无统计学意义(P>0.05)。结论 负荷量阿司匹林、氯吡格雷联合低分子肝素治疗TIA疗效显著,安全可靠。     

氯吡格雷与阿司匹林联合方案治疗急性心肌梗死临床疗效分析

目的分析氯吡格雷与阿司匹林联合方案治疗急性心肌梗死的效果，探索急性心肌梗死的有效治疗方案。方法随机选取2012年11月～2013年9月治疗的急性心肌梗死患者共190例；随机分为两组，其中应用氯吡格雷与阿司匹林联合方案治疗的96例患者为观察组，应用院阿司匹林治疗的94例为对照组，应用回顾性分析两组患者的预后情况。结果观察组冠脉再通率77．1％，不良反应率12．5％，死亡率1．01％；对照组冠脉再通率为58．5％，不良反应率18．1％，死亡率9．6％，经统计学比较，存在统计学差异（P〈0．05）。结论氯吡格雷与阿司匹林联合方案能够改善急性心肌梗死预后效果，降低死亡率，值得临床广泛应用。     

替格瑞洛用于急性冠脉综合征行药物洗脱支架植入患者抗血小板治疗有效性及安全性分析

目的探讨替格瑞洛对急性冠脉综合征行药物洗脱支架植入患者抗血小板治疗的有效性及安全性。方法选取4 401例接受药物洗脱支架植入的急性冠脉综合征患者,在规律应用阿司匹林的基础上(300 mg负荷剂量,100 mg 1次/d),联用替格瑞洛(180 mg负荷剂量,90 mg 2次/d)或氯吡格雷(300~600 mg负荷剂量,75 mg 1次/d),并根据联合用药分为替格瑞洛组和氯吡格雷组。研究终点为术后1年内的有效性终点事件(心血管死亡、心肌梗死、缺血性脑卒中、支架内血栓及复合终点事件)和安全性终点事件(根据美国出血学术研究会制定的标准定义划分的全部出血、大出血和小出血事件)。结果替格瑞洛组的有效性的复合终点事件(HR=0.64,95%可信区间0.42~0.99,P<0.05)和心血管死亡事件(HR=0.07,95%可信区间0.02~0.30,P<0.01)明显低于氯吡格雷组,且安全性终点中大出血事件,差异无统计学意义(HR=0.97,95%可信区间0.50~1.87,P>0.05),但替格瑞洛组小出血和总出血事件明显高于氯吡格雷组。结论对于急性冠脉综合征行药物洗脱支架植入的患者,替格瑞洛与氯吡格雷相比能够明显减少血栓事件再发风险且不增加致命性大出血事件。     

Clopidogrel plus long-term aspirin after femoro-popliteal stenting. The CLAFS project: 1- and 2-year results

The aim of this study was to determine the patency rate after femoro-popliteal stenting followed by oral clopidogrel plus long-term aspirin. In a prospective trial, 31 patients with a total of 33 femoro-popliteal artery lesions (21 stenoses, 12 occlusions; 24 femoral, 9 popliteal) were treated with flexible tantalum stents after unsuccessful percutaneous transluminal angioplasty (PTA) preceded by local fibrinolysis in 5 of 12 patients with total occlusion. Post-interventionally, oral aspirin 100 mg was started simultaneously for the long term and was combined with an oral loading dose of 300 mg clopidogrel, followed by 75 mg clopidogrel daily for 28 days. Patients were followed for at least 12 months (maximum 34 months) by clinical examination, Doppler pressure measurement, color and duplex sonography, and angiography in case of suspicion of restenosis. In a retrospective analysis, the results were compared with those of historical groups of patients having received aspirin only (41 patients) or a long-term high-dose low molecular weight heparin (LMWH)+aspirin treatment (42 patients). Three small puncture aneurysms were treated successfully by conservative means and were categorized as minor bleeding complication. Cumulative primary patency rate (PPR) was 76±7.5% (1 year), and 70±9.6% (2 years) in the clopidogrel+aspirin group, thus being tendentiously better than in the aspirin-only group showing 75±4.6% (1 year), and 50±8.1% (2 years). Long-term high-dose LMWH+aspirin treatment showed 87±5.8% (1 year), and 72±9.1% (2 years), thus being superior to the other treatment regimes, with a statistically significant difference (p<0.05) between the LMWH+aspirin and the aspirin group. Clopidogrel plus aspirin is a safe medication regimen and may be effective in the prevention of early stent thrombosis. Mid- and long-term patency rate seems to be intermediate as compared with other therapeutic regimens. The LMWH+aspirin seems to be superior compared with CLAFS; however, randomized studies with larger patient numbers are recommended.     

Management of peripheral arterial interventions with mono or dual antiplatelet therapy—the MIRROR study: a randomised and double-blinded clinical trial

Objectives

To investigate the influence of dual antiplatelet therapy vs. aspirin alone on local platelet activation and clinical endpoints in patients with PAD treated with endovascular therapy.

Methods

Patients received either 500?mg aspirin and 300?mg clopidogrel before intervention followed by a daily dose of 100?mg aspirin and 75?mg clopidogrel for 6 months, or the same doses of aspirin plus placebo instead of clopidogrel. Primary endpoints were local concentrations of platelet activation markers β-thromboglobulin and CD40L, and the rate of patient’s resistant to clopidogrel. Secondary endpoints included the clinical development 6?months after the intervention.

Results

Eighty patients, 40 in each group, were enrolled. The median peri-interventional concentration of β-TG was 224.5 vs. 365.5 (P?=?0.03) in the clopidogrel and placebo group. The concentration of CD40L was 127 and 206.5 (P?=?0.05). Thirty per cent of patients who had received clopidogrel were resistant. Two clopidogrel and eight placebo patients required TLR (P?=?0.04). The clopidogrel patients who needed revascularisation were both resistant to clopidogrel. Minor bleeding complications occurred in one clopidogrel and two placebo patients.

Conclusion

Dual antiplatetet therapy reduces peri-interventional platelet activation and improves functional outcome without higher bleeding complications. An individual tailored dual antiplatelet therapy seems desirable for endovascularly treated patients with PAD.

Key Points

? The role of clopidogrel and aspirin following endovascular therapy was investigated. ? Dual antiplatelet therapy reduces peri-interventional platelet activation more than aspirin alone. ? Dual antiplatelet therapy improves the outcome of endovascularly treated patients. ? Clopidogrel resistance is important when treating peripheral arterial disease endovascularly.     

奥扎格雷钠联合阿司匹林治疗急性脑梗死的临床研究

目的 观察奥扎格雷钠联合阿司匹林治疗急性脑梗死的临床疗效和安全性.方法发病后6-48 h入院的非心源性急性脑梗死患者随机分为两组,A组（n=65）给予奥扎格雷钠（80 mg/次,2次/d）＋阿司匹林肠溶片（100 mg/次,1次/d）,B组（n=65）给予阿司匹林肠溶片（100 mg/次,1次/d）,疗程均为14 d.治疗前后均进行神经功能缺损量表（NIHSS）评分和肌力测评,并观察治疗期间发生的不良反应及出血性并发症.结果两组治疗后14 d,神经功能缺损程度较基线水平均明显改善（P＜0.01）,而A组的神经功能缺损症状及肌力恢复均显著优于B组（P＜0.01）;A组发生1例出血性转化,4例血尿;B组发生1例血尿,两组均无消化道出血,两组在出血并发症方面无显著性差异（P＞0.05）.结论 对于发病后6~48 h就医的急性脑梗死,奥扎格雷钠联合阿司匹林是一种安全、有效的治疗方法.     

氯吡格雷联合阿司匹林对老年稳定型心绞痛的疗效及其预后影响

 目的 分析氯吡格雷联合阿司匹林对老年稳定型心绞痛的疗效及远期预后的影响。方法 选取2013-09至2016-09西部战区总医院180例老年稳定型心绞痛患者作为研究对象,根据入院顺序将患者分为研究组和对照组,每组90例。对照组在常规治疗基础上给予口服阿司匹林肠溶片(100 mg/d)进行治疗,研究组在对照组疗法基础上口服硫酸氢氯吡格雷片(75 mg/d)进行治疗。两组均连续给予抗血小板治疗3个月。检测并比较两组治疗前、后的凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、血小板凝集率(PAR)、左心室射血分数(LVEF)、每搏输出量(SV)及血浆D二聚体(D-D)、纤维蛋白原(FIB);进行2年的随访,对两组治疗期间不良反应发生率、不稳定型心绞痛、心肌梗死、心源性猝死等心血管事件发生率、无心血管事件生存期进行对比分析。结果 治疗后,两组的PT、APTT、LVEF、SV水平均较治疗前升高,FAR、D-D、FIB水平均较治疗前降低,差异有统计学意义(P<0.05),研究组PT、APTT、LVEF、SV水平均高于对照组,FAR、D-D、FIB水平均低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率的差异无统计学意义。在随访发现,两组的心血管事件发生率、平均无心血管事件生存期的差异无统计学意义。结论 老年稳定型心绞痛治疗中应用氯吡格雷联合阿司匹林,能够提高抗血小板治疗效果,降低凝血系统活性,具有较高的安全性。对于患者远期预后的改善作用还需要进一步研究。     

Prevalence and risk factors for aspirin and clopidogrel resistance in cerebrovascular stenting

BACKGROUND AND PURPOSE: The prevalence of antiplatelet drug resistance among patients who undergo cerebrovascular stent placement is unknown. We aimed to assess the feasibility of monitoring antiplatelet drug effects in a single-center cohort undergoing cerebrovascular stent placement.MATERIALS AND METHODS: We prospectively collected medical, laboratory, and radiographic data on patients who underwent cerebrovascular stent placement. We used the rapid platelet function assay-aspirin (RPFA-ASA) to calculate aspirin reaction units (ARU) and the P2Y12 assay to calculate P2Y12 reaction units and percentage platelet inhibition. Aspirin resistance was defined as ARU > 550, whereas clopidogrel resistance was defined as percentage platelet inhibition < 40%.RESULTS: Among 76 patients, stent indications were the following: wide-neck aneurysm (57, 75.0%), symptomatic intracranial stenosis (12, 15.7%), carotid stenosis (5, 6.6%), and vertebral stenosis (2, 2.6%). For aspirin, the median dosage per week was 1300 mg and median ARU was 410. Among 71 patients on aspirin, 3 patients (4.2%) were resistant; there was a significant inverse correlation between aspirin dose and ARU (r = −0.31, P = .01). Among 55 patients on clopidogrel, the median dosage per week was 525 mg with a mean platelet inhibition of 43.2%. Twenty-eight patients (51.9%) were clopidogrel-resistant. In a multivariable linear regression model, age older than 55 years (b = −16.3, P = .020) and diabetes (b = −26.8, P = .015) were inversely related to percentage platelet inhibition.CONCLUSIONS: Using point-of-care tests, we found that aspirin resistance is relatively uncommon, whereas clopidogrel resistance occurred in half of patients undergoing cerebrovascular stent placement. Further studies should focus on ideal doses, timing, and duration of antiplatelet therapy for cerebrovascular stent placement.

Although there is widespread use of endovascular stents in the treatment of coronary and peripheral arterial disease, the use of cerebrovascular stents has only emerged during the past decade. Indications include extracranial and intracranial large-artery stenosis and endovascular treatment of wide-neck cerebral aneurysms. Antithrombotic therapy is often used to combat the risk of stent thrombosis and re-stenosis associated with bare metal stents. Following percutaneous coronary intervention, aspirin and clopidogrel are routinely considered “standard of care.” On the basis of the current American Heart Association guidelines, dual antiplatelet therapy is recommended for 1 month following bare metal coronary stent placement and for up to 6–12 months for drug-eluting stents.¹ Extrapolating from this clinical practice, combination antiplatelet therapy has also been increasingly used in patients undergoing cerebrovascular stent placement, for which higher rates of re-stenosis have been reported.^2–4 However, little data exist to guide this practice.Given the importance of platelet inhibition in the prevention of in-stent thrombosis and re-stenosis, there is a great incentive to ensure that adequate antiplatelet effects are achieved in such high-risk patients. Platelet inhibition from aspirin and clopidogrel varies broadly, and some patients are low responders or are classified as being “resistant.” In coronary patients undergoing stent placement, significant proportions have aspirin and clopidogrel resistance.^5,6 There are no data on responses to aspirin and clopidogrel among patients who undergo cerebrovascular stent placement. Therefore, in a single-center prospective cohort by using point-of-care platelet function assays, we aimed to test the feasibility of monitoring antiplatelet drug effects, determine the prevalence of aspirin and clopidogrel resistance, and identify predictors of decreased antiplatelet response.     

Comparison of diclofenac sodium and aspirin in the treatment of acute sports injuries

A randomized, double-blind, parallel-group clinical trial compared diclofenac sodium (Voltaren, Ciba-Geigy Summit, NJ) with aspirin for the treatment of acute sprains and/or strains of the knee or ankle. One hundred thirty-nine patients were admitted to the study. Patients received either 150 mg (75 mg twice daily) of diclofenac (N = 69) or 3.6 g (1.2 g three times daily) of aspirin (N = 70) for 3 to 10 days. Forty-seven diclofenac patients and 49 aspirin patients, mean age for both groups 25 years, were evaluated to determine the efficacy of each treatment. Both groups experienced significant (P less than 0.001) improvements for all efficacy variables measured. Treating sprains and strains with diclofenac rather than with aspirin allowed an earlier return to activity. Of those patients who achieved playing fitness, those in the diclofenac group resumed athletic activities in a mean of 4.7 days, compared with a mean of 5.9 days for patients in the aspirin group. Although the overall multivariate F was nonsignificant (P = 0.19), the univariate F for days required to resume playing fitness was significantly (P = 0.025) shorter in the diclofenac group. While the nonsignificant multivariate result suggests that the significance may be due to chance, it is also possible that there was a trend toward earlier resumption of activities with diclofenac treatment compared to aspirin, but an insufficient sample size to demonstrate the trend statistically. Since others have reported such a trend without the greater controls of a multivariate analysis, this area warrants further research.     

肝素联合阿司匹林治疗抗磷脂综合征

目的：探讨肝素联合阿司匹林治疗抗磷脂综合征的疗效。方法：分析42例患者治疗前后的情况。结果：统计学分析表明，42例抗磷脂综合征患者治疗后，不孕症及胎儿宫内发育迟缓较治疗前有显著性差异，习惯性流产、早产、胎死宫内和妊娠高血压综合征与治疗前相比无显著差异。结论：肝素联合阿司匹林治疗抗磷脂综合征安全有效。     

银杏叶提取物对氯吡格雷人体内药动学影响

  目的 探讨银杏叶提取物对氯吡格雷人体内药动学影响及其相关机制。方法 选取14名健康男性志愿者,第一阶段服用氯吡格雷150 mg/d(单用药组);第二阶段进洗脱期后,受试者连续服用银杏叶提取物240 mg/d,连续14 d,第14天给予银杏叶提取物1 h后,再空腹服用氯吡格雷(联用药组)。两组均在给药后采集受试者0~24 h外周静脉血,检测氯吡格雷代谢产物SR-26334的浓度。此外,建立体外Caco-2细胞模型,以罗丹明-123和维拉帕米分别为阴性和阳性对照,采用流式细胞技术检测银杏叶提取物和氯吡格雷对Caco-2细胞内的荧光强度的影响。结果 联合用药组受试者血中SR26334的AUC_(0-t)(3192.3±45.035)[(mg·h)/L]、AUC_(0-∞)(3343.017±43.829)[(mg·h)/L]和C_max(340.988±11.257)[(mg·h)/L]均高于单独用药组,CL/F(0.071±0.007)低于单独用药组(P<0.05)。Caco-2细胞内荧光强度,银杏叶提取物组(487±14.12)和联合用药组(497±17.22)高于阴性对照组(P<0.05)。结论 银杏叶提取物能显著提高氯吡格雷羧酸在人体内的生物利用度和吸收总量,其作用机制可能与银杏叶对P-糖蛋白(P-gp)的抑制作用有关。     

噻氯匹定与阿司匹林对不稳定心绞痛的临床疗效比较

目的比较噻氯匹定和阿司匹林治疗不稳定心绞痛的临床疗效。方法将不稳定心绞痛患者48例,随机分成两组,试验组为噻氯匹定组,共22例;对照组为阿司匹林组,共26例。试验组予噻氯匹定250mg,2次/d口服,1周后改为250mg,1次/d口服,再服1周后改为阿司匹林100mg,1次/d口服。对照组给予阿司匹林300mg,1次/d口服,3d后改为100mg,1次/d口服。对比治疗1周及4周的严重心血管事件及心绞痛发生率。结果噻氯匹定组在近期AMI发生率及死亡率与对照组比较,虽无明显差异(P>0.05),但噻氯匹定组能明显降低患者的心绞痛发生率,两组相比,差异显著(P<0.05)。结论噻氯匹定治疗不稳定心绞痛疗效优于阿司匹林。