氯吡格雷对缺血性脑血管病患者阿司匹林抵抗影响的临床研究

目的观察氯吡格雷对缺血性脑血管病患者阿司匹林抵抗（AR）的影响。方法采用全血电阻法检测88例缺血性脑血管病患者ADP诱导的血小板聚集率（PAG）,将合并AR者随机分为阿司匹林加氯吡格雷治疗组（AR-A）和阿司匹林治疗组（AR-B）,阿司匹林敏感（AS）者为敏感对照组,分别于治疗1周、2周及4周后,再次测定ADP诱导的PAG,比较各组治疗前后PAG的变化。结果缺血性脑血管病患者中,出现AR 28例（32%）。治疗2周后,AR-A组ADP诱导的PAG较治疗前明显下降,AR-B组PAG较治疗前无明显改变（P〈0.01）。治疗4周后,各组PAG较2周时无统计学差异（P〉0.05）。结论缺血性脑血管病患者中,AR的发生率较高,联合氯吡格雷治疗可以改善其AR状态。

Influence of clopidogrel bisulfate on aspirin resistance in patients with ischemic cerebrovascular disease

Objective To explore the effect of clopidogrel bisulfate on aspirin resistance（AR） in patients with ischemic cerebrovascular disease.Methods The platelet aggregation fraction（PAG） induced by adenosine diphosphate（ADP） of 88 patients with ischemic cerebrovascular disease was detected and the accidence of AR was evaluated.Patients with AR were divided into three groups randomly： AR-A group（treated by clopidogrel bisulfate and aspirin）,AR-B group（treated by aspirin） and control group（patients with aspirin sensitive）.Their PAG at the 1st,2nd and 4th week after medication were observed and compared.Results The accidence of AR in patients with ischemic cerebrovascular disease was 32%.After medication,the PAG in AR-A group was reduced compared with that two weeks ago,however,no change of PAG was observed in AR-B group after two weeks（P0.01）.No difference of PAG was detected between taking two weeks medication and taking four weeks medication（P0.05）.Conclusion Taking clopidogrel bisulfate combined with aspirin may be beneficial to improve AR in patients with ischemic cerebrovascular disease.