摘要
目的探讨高维持剂量（150mg／d）氯吡格雷与替格瑞·临床疗效对比。方法筛选郑州大学第一附属医院稳定型心绞痛氯吡格雷CYP2C19基因型慢代谢患者64例，分为两组；A组给予氯吡格雷负荷剂量300mg，维持剂量150mg／d，B组给予替格瑞洛负荷剂量180mg，维持量180mg／d，分别于给药前、给药后2h、30d光比浊法测定两组血小板聚集率（IPA）值。随访30d观测两组的MACE和出血事件。结果替格瑞洛对血小板抑制作用强于高维持剂量氯吡格雷组（P〈0．01），氯吡格雷组发生2例MACE事件，替格瑞洛组无发生；替格瑞洛组出血事件高于氯吡格雷组（P〈0．01）。结论在氯吡格雷慢代谢稳定型心绞痛患者抗血小板治疗中，替格瑞洛临床疗效优于氯吡格雷，但次要出血事件发生率增加。
Objective To investigate the antiplatelet effects of high maintenance dose of clopidogrel and ticagrelor. Methods Sixty-four patients with stable coronary artery disease were screened from our hospital as poor clopidogrel metabolizer according to CYP2C19 gene type. They were divided into two groups. Group A was treated with clopidogrel with loading dose of 300 mg at the first time and 150 mg/d for 30 days; Group B was treated with ticagrelor loading with the dose of 180 mg and 90 mg,twice one day. Platelet function was measured by aggregometry ADP induced at preloading, 2 hours after loading does and 30 days after maintenance dose. All patients were followed-up with major adverse cardiovascular events（MACE） and bleeding events for 30 days. Results The antiplatelet effect of ticagrelor was higher than that of high maintenance dose of clopidogrel（P 〈0.01 ） ; There were two MACE events in clopidogrel groups, but none in ticagrelor groups for 30 days. Minor bleeding events in ticagrelor group was higher than that in clopidogrel group （P 〈 0. 01 ）. Conclusions In clopidogrel slow metabolism of antiplatelet therapy in patients with stable angina. The clinical curative effect of ticagrelor is superior to clopidogrel, but with higher minor bleeding events.
出处
《中国实用医刊》
2015年第5期43-45,共3页
Chinese Journal of Practical Medicine
