氯吡格雷对急性冠脉综合征患者阿司匹林抵抗的影响

【目的】研究氯吡格雷对急性冠脉综合征（ACS）阿司匹林抵抗患者的治疗价值。【方法】将79例ACS病人分为两组，阿司匹林组39例，入院后3d内口服阿司匹林300mg／d，后改为100mg／d至两周；联合用药组40例，阿司匹林服用如前，同时加用氯吡格雷75mg／d。于两周时采静脉血，应用比浊法分别测定二磷酸腺苷（ADP）和花生四烯酸（AA）诱导的血小板集聚率。【结果】联合用药组与阿司匹林组相比，两种不同诱导剂诱导的血小板平均集聚率均明显下降（P〈0．05或P〈70．01），其中以ADP诱导的血小板平均集聚率下降更显著，联合用药组阿司匹林抵抗（AR）与阿司匹林半抵抗（ASR）总发生率较单用阿司匹林组明显为低（P〈0．05）。【结论】氯吡格雷用于ACS可明显减少阿司匹林抵抗，从而减少不良心血管事件的发生。

Research on Clopidogrel for Improving the Aspirin Resistance in Acute Coronary Syndrome Patients

[Objective]To investigate the value of clopidogrel for the treatment of aspirin resistance in acute coronary syndrome （ACS） patients. [Methods]Seventy nine patients with ACS were randomized into as pirin group and combined treatment group. Aspirin group（ n = 39） were treated with aspirin 300mg/d after the first three days in hospital, and 100 mg/d after then till two weeks. Combined treatment group（ n=40） were added with clopidogrel （75 mg/d） besides the above medications. The patients platelet aggregation in duced by adenosine disphosphate （ADP） and arachidonic acid （AA） was evaluated by turbidity method. [Re suits]In comparison with aspirin group, combined treatment group showed lower ADP induced and AA induced platelet aggregation （ P〈0.05 and P〈0.01 ） . The incident of aspirin resistance and aspirin semi-re sistance in the combined treatment group was lower than that in the aspirin group （ P〈0.05）. [Conclusion] Clopidogrel combined with aspirin in treatment of ACS can obviously decrease the aspirin resistance, and further to reduce the incidence of adverse cardiovascular events.