奥美拉唑对急性冠脉综合征患者氯吡格雷抗血小板聚集率的影响

目的 观察奥美拉唑对急性冠脉综合征（ACS）患者氯吡格雷抗血小板聚集率（PRI）的影响.方法 选择ACS患者159例,在给予标准化治疗的基础上,根据病情需要分为两组,其中一组给予奥美拉唑（20 mg/d）治疗（治疗组,65例）,另一组未使用（对照组,94例）,两组均给予阿司匹林（100 mg/d）和氯吡格雷（75 mg/d）维持治疗,5d后检测两组患者PRI和氯吡格雷活性代谢产物浓度（clopi-H4）.结果 治疗5d后,治疗组与对照组中患者PRI＞ 50％分别为12例（18.5％）和7例（7.4％）（Х^2=4.431,P＜0.05）,clopi-H4分别为332.8 mmol/L（标准差SD 371.8）和600.3 mmol/L（标准差SD 885.2）（t=-2.298,P＜0.05）.结论 ACS患者联合使用奥美拉唑及氯吡格雷,可降低clopi-H4,抑制氯吡格雷抗血小板聚集作用.

Influence of proton pump inhibitors omeprazole on the platelet aggregation rate of clopidogrel in patients with acute coronary syndrome

Objective To explore the influence of proton pump inhibitors （PPI）omeprazole on the platelet aggregation rate of clopidogrel in patients with acute coronary syndrome （ACS）.Methods A total of 159 patients with ACS were selected,based on the standardized treatment,the patients were divided into the two groups according to the illness.65 cases in the treatment group were given omeprazole （20mg/d）.94 cases in the control group were not given omeprazole.Both two groups were given aspirin（100mg/d） and clopidogrel （75mg/d）.The platelet reactivity index（PRI） and clopidogrel active metabolites （clopi-H4）were detected five days later.Results After treatment for 5 days,the number of PRI 〉 50% in the treatment group and control group was 12 cases（18.5%） and 7 cases （7.4%） （Х^2 =4.431,P 〈 0.05）.The clopi-H4 levels in the treatment group and control group were 332.8 mmol/L （SD 371.8） and 600.3 mmol/L（SD 885.2） （t =-2.298,P 〈 0.05）.Conclusion In patients with ACS,combined omeprazole and clopidogrel can reduce the concentration of clopidogrel active metabolites clopi-H4,inhibition of clopi dogrel platelet aggregation.