瑞舒伐他汀和阿托伐他汀对氯吡格雷抗血小板活性的影响

目的观察瑞舒伐他汀和阿托伐他汀对氯吡格雷抗血小板活性的影响。方法选择60例冠心病患者接受阿司匹林100mg/d、氯吡格雷75 mg/d及低分子肝素5000 U/12 h治疗,5 d后随机分为阿托伐他汀20mg/d(阿托伐他汀组,30例)和瑞舒伐他汀10 mg/d(瑞舒伐他汀组,30例)。在服用氯吡格雷之前(基线值)、加用他汀类药物之前及服用他汀类药物3d后,用全血阻抗法分别测定不同浓度二磷酸腺苷(5、10、20μmol/L)诱导的血小板聚集率。结果与基线值比较,服用氯吡格雷5 d后和加服他汀类药物治疗3 d后,2组患者血小板聚集率明显降低,差异有统计学意义(P<0.05);与治疗前比较,阿托伐他汀组患者血小板聚集率有所升高,而瑞舒伐他汀组患者血小板聚集率有所下降,但差异无统计学意义(P>0.05)。结论经细胞色素3A4途径代谢的阿托伐他汀及不经细胞色素3A4代谢的瑞舒伐他汀,短期内对氯吡格雷抗血小板活性无影响。

The influence of atorvastatin or rosuvastatin on antiplatelet activity of clopidogrel

Objective To observe the influence of rosuvastatin or atorvastatin on platelet aggregation in patients treated with clopidogrel.Methods A total of 60 hospitalized patients with coronary heart disease received antiplatelet and anticoagulation treatment including aspirin 100 mg/d, clopidogrel 75 mg/d,and low molecular weight heparin 5000 U/12 h.Five days after receiving the above medication,the patients were randomized to atorvastatin 20 mg/d treatment group(Group A,n = 30),and rosuvastatin 10 mg/d treatment group(Group R,n = 30).Platelet aggregation induced by adenosine diphosphate(ADP) 5,10,and 20μmol/L was measured with whole blood impedance method on the day before clopidogrel therapy(baseline),the day before statin therapy, and 3 days after statin therapy.Results ADP-induced platelet aggregation was significantly decreased by clopidogrel therapy(P<0.05),but no statistical difference was observed under additional treatment with atorvastatin or rosuvastatin(P>0.05).Conclusion Neither atorvastatin nor rosuvastatin attenuates the antiplatelet effects of clopidogrel during short-term co-medication.