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冠脉支架术后阿托伐他汀联用氯吡格雷两药相互作用的随访研究(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2008年第5期
页码:
577-580
栏目:
临床研究
出版日期:
2008-10-20

文章信息/Info

Title:
Study of atorvastatin and clopidogrel interaction in patients undergoing coronary stenting in a longtime treatment
作者:
段继源; 郭文怡; 谢晓莉; 张荣庆; 刘丽珍; 袁铭; 范延红
第四军医大学西京医院心内科，陕西 西安 710032
Author(s):
DUAN Jiyuan;  GUO Wenyi;  XIE Xiaoli;  ZHANG Rongqing;  LIU Lizhen;  YUAN Ming;  FAN Yanhong
Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, Shaanxi, China
关键词:
阿托伐他汀; 氯吡格雷; 冠状动脉成形术; 经腔; 经皮; 药物的相互作用
Keywords:
atorvastatin;  clopidogrel;  coronary angioplasty;  transluminal;  percutaneous;  drug interaction
分类号:
R972
DOI:
-
文献标识码:
A
摘要:
目的 研究在冠脉支架术后随访患者中不同剂量的阿托伐他汀与氯吡格雷长期联用产生的药物相互影响。方法 105例冠心病患者，入院第2天随机服用阿托伐他汀和普伐他汀，66例行PCI术者入院当日加服氯吡格雷。共分为5组，A组23例，阿托伐他汀20 mg/d+氯吡格雷，B组20例，阿托伐他汀40 mg/d+氯吡格雷，C组23例，普伐他汀20 mg/d+氯吡格雷，D组20例，单用阿托伐他汀20 mg/d，E组19例，单用阿托伐他汀40 mg/d。分别在入院第1天及出院随访1、3月测定A、B、C组患者的血小板功能指标，并进行比较，测定各组的血脂等指标，分别比较A和D组、B和E组血脂等指标的差异。结果 各组患者临床特征基线资料比较，差异无统计学意义；A、B、C组患者首次及随访1、3月测定的血小板功能指标CD62P、CD63、MPAR，组间差异无统计学意义，3组中各指标1、3月比基线均略有所下降（P<0.05），但1月和3月比较差异无统计学意义，CD62P、CD63、MPAR互为正相关（P<0.05）；A和D组、B和E组在首次及治疗1、3月后相比较，血脂等在两对应组间差异均无统计学意义。结论 冠脉支架术后40 mg/d以下的阿托伐他汀与常规剂量氯吡格雷较长时间联用，两药之间相互无明显影响，合用是安全的。
Abstract:
AIM To study the interaction of the different doses of atorvastation and clopidogrel in patients undergoing coronary stenting in a longtime treatment. METHODS A total of 105 patients with coronary heart diseases were treated with different doses of atorvastatin or pravastatin randomly in the hospital the day after hospitalization and 66 patients undergoing successful percutaneous coronary intervention (PCI) were treated with clopidogrel. The 105 patients were divided into 5 groups: 23 patients in group A, atorvastatin 20 mg/d plus clopidogrel; 20 patients in group B, atorvastatin 40 mg/d plus clopidogrel; 23 patients in group C, pravastatin 20 mg/d plus clopidogrel; 20 patients in group D, only atorvastatin 20 mg/d; and 19 patients in group E, only atorvastatin 40 mg/d. The expressions of platelet CD62P, CD63 and the maximal platelet aggregation rate (MPAR) and other plasma lipids were measured at the first day after admission and 1 or 3 months after treatment. The difference of the platelet functions was compared between groups A, B and C. The difference of plasma lipid, ALT and CK was compared between groups A and D, group B and E. RESULTS No significant difference was observed in the baseline clinical characteristics between the 5 groups. The levels of CD62P, CD63 and MPAR measured 3 times in groups A, B and C were not significantly different between the groups. Though the levels measured at 1 and 3 months declined slightly compared with the baseline data（P<0.05） no significant difference was found between levels measured at 1 and 3 months. CD62P, CD63 and MPAR were positively correlated with each other. There were no statistic difference in the levels of plasma lipid, ALT and CK between groups A and D, groups B and E in 1 or 3 months after treatment. CONCLUSIONNo drug interaction has been found in a longtime combined administration of atorvastatin below 40 mg/d and clopidogrel after PCI and longtime combined administration is safe.

参考文献/References

［1］ Lau WC, Waskell LA, Watkins PB, et al. Atorvastatin reduces the ability of clopidogrel to inhibit platelet aggregation: a new drugdrug interaction［J］. Circulation, 2003, 107(1):32-37.

［2］ Neubauer H, Gunesdogan B, Hanefeld C, et al. Lipophilic statins interfere with the inhibitiry effects of clopidogrel on platelet function flow cytometry study［J］. Eur Heart J, 2003, 24(19):1744-1749.

［3］ Mitsios JV, Papathanasiou AI, Rodis FI, et al. Atorvastatin does not affect the antiplatelet potency of clopidogrel when it is administered concomitantly for 5 weeks in patients with acute coronary syndromes［J］. Circulation, 2004, 109(11):1335-1338.

［4］ 韩雅玲，李成洋，李毅，等. 急性冠状动脉综合征冠状动脉支架术后应用他汀类药物对氯吡咯雷抗血小板作用无影响［J］. 中华心血管病杂志, 2007, 35(9):788-792.

［5］ Malhotra HS, Goa KL. Atorvastatin: An updated review of its pharmacological properties and use in dyslipidaemia［J］. Drugs, 2001, 61(12):1835-1881.

［6］ Chopra V, Marmur JD, Cavusoglu E. The role of clopidogrel in the management of patients with ischemic heart disease［J］. Cardiovasc Drugs Ther, 2003, 17(5-6):467-477.

［7］ Angiolillo DJ, FernandezOrtiz A, Bernardo E, et al. Contribution of gene sequence variations of the hepitic cytochrome P450 3A4 enzyme to variability in individual responsiveness to clopidogrel［J］. Arterioscler Thromb Vasc Biol, 2006, 26(8):1895-1900.

［8］ Clarke TA, Waskell LA. The metabolism of clopidogrel is catalyzed by human cytochrome P450 3A and is inhibited by atorvastatin［J］. Drug Metab Dispos, 2003, 31(1):53-59.

［9］ Trenk D, Hochholzer W, Frundi D, et al. Impact of cytochrome P450 3A4metabolized statins on the antiplatelet effect of a 600mg loading dose clopidogrel and on clinical outcome in patients undergoing elective coronary stent placement［J］. Thromb Haemost, 2008, 99(1):174-181.

［10］Bledsoe SL, Barr JC, Fitzgerald RT, et al. Pravastatin and clopidogrel combind inhibit intimal hyperplasia in a rat carotid endarterectomy model［J］. Vasc Endovascular Surg, 2006, 40(1):49-57.

备注/Memo

备注/Memo:
收稿日期：2008-03-13.通讯作者：郭文怡，主任医师，主要从事冠心病的研究及治疗Email:guowenyi@tom.com 作者简介：段继源，主治医师，硕士生Email:msg555@126.com
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