他汀类药物对急性冠脉综合征患者应用氯吡格雷抗血小板功能的影响

目的：观察阿托伐他汀或普伐他汀对急性冠脉综合征（ACS）患者应用氯吡格雷抗血小板功能的影响。方法：150例行经皮冠状动脉介入治疗（PCI）的ACS患者，入院后给予阿司匹林300mg／d，氯吡格雷负荷量300mg继以维持量75mg／d的抗血小板治疗，并随机分为A阿托伐他汀组（A120mg／dn=30，A240mg／dn=30，A380mg／dn=30）、B普伐他汀组（20mg／d，n=30）和C无他汀组（n=30）。采用ELISA法检测血浆CD62P、CD63含量及比浊法检测血小板最大聚集率（MPAR）。结果：他汀治疗前后，A组、B组、C组上述指标的差值组间比较均无明显差异（P〉0．05）；A1组、A2组、A3组与C组相比，治疗前后上述指标的差值组间比较亦无明显差异（P〉0．05）。结论：阿托伐他汀不抑制氯吡格雷的抗血小板活性。

Effect of statins on antiplatelet activity of clopidogrel in patients with acute coronary syndrome

Objective:To investigate the effect of atorvastatin and pravastatin on antiplatelet activity of clopidogrel in the patients with acute coronary syndrome(ACS).Methods:A total of 150 hospitalized patients with ACS treated by PCI were divided randomly into atorvastatin group(group A,and 20 mg/d atorvastatin in A1 n=30,40 mg/d in A2 n=30,80 mg/d in A3 n=30),pravastatin group(group B,20 mg/d n=30),and no statins group(group C,n=30).All patients received antiplatelet treatment including 300 mg/d aspirin and 300 mg clopidogrel as loading dose followed by 75 mg/d as maintenance dose.Plasma CD62P and CD63 were measured by ELISA method and the maximal platelet aggregation rate(MPAR)was measured by turbidity method.Results:There was no significant difference among three groups at the reductions of CD62P,CD63 and MPAR before and after stains ingestion(P>0.05).When 3 subsets of group A were compared with group C,there were still no significant diferrences in the reductions of CD62P,CD63 and MPAR(P>0.05).Conclusion:Atorvastatin dose not inhibit the antiplatelet activity of clopidogrel.