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不同质子泵抑制剂对冠脉支架术后氯吡格雷抗血小板功能的影响(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2012年第3期
页码:
353-357
栏目:
临床研究
出版日期:
2012-06-25

文章信息/Info

Title:
Impact of different proton pump inhibitors or H2 receptor antagonists on antiplatelet activity of clopidogrel in patients undergoing coronary stent implantation
作者:
王 艳; 袁 铭; 魏丽萍; 石小朋; 李春红; 贺 媛; 郭文怡
(第四军医大学西京医院心内科，陕西 西安 710032)
Author(s):
WANG Yan;  YUAN Ming;  WEI Li-ping;  SHI Xiao-peng;  LI Chun-hong;  HE Yuan;  GUO Wen-yi
(Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, Shaanxi, China)
关键词:
冠状动脉疾病; 质子泵抑制剂; H2受体拮抗剂; 氯吡格雷; 血小板聚集功能
Keywords:
coronary disease;  proton pump inhibitor;  H2 receptor antagonists;  clopidogrel;  platelet aggregation
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的:观察埃索美拉唑、雷贝拉唑、雷尼替丁或法莫替丁对急性冠脉综合症（ACS）患者冠脉支架术后应用氯吡格雷抗血小板功能的影响。方法： 150例行经皮冠状动脉介入治疗（PCI）的ACS患者，入院后给予阿司匹林300 mg/d,氯吡格雷300 mg负荷剂量继以75 mg/d维持剂量抗血小板治疗，并随机分为质子泵抑制剂（PPI）A组（A1组：埃索美拉唑40 mg/d，n=30，A2组：雷贝拉唑20 mg/d，n=30）、H2受体拮抗剂(H2RA)B组（B1组：雷尼替丁300 mg/d，n=30，B2组：法莫替丁40 mg/d，n=30）和空白对照C组（C组：n=30）。采用ELISA法检测血浆CD62P、GPⅡb/Ⅲa含量及电阻抗法检测血小板聚集功能。结果： PPI或H2RA治疗前后，A组、B组与C组相比，上述指标的差值组间比较均无明显统计学差异，A1组、A2组、B1组、B2组与C组相比，治疗前后上述指标的差值组间比较均无统计学差异。结论： 埃索美拉唑、雷贝拉唑、雷尼替丁或法莫替丁对氯吡格雷的抗血小板活性无明显的影响。
Abstract:
AIM:To investigate the effect of esomeprazole, rabeprazole, ranitidine and famotidine on antiplatelet activity of clopidogrel in patients with acute coronary syndrome (ACS). METHODS: A total of 150 hospitalized ACS patients treated with PCI were randomly divided into proton pump inhibitor (PPI) group (group A: and 40 mg/day esomeprazole in A1, n=30; 20 mg/day rabeprazole in A2, n=30); H2 receptor antagonists (H2RA) group (group B: and 300 mg/day ranitidine in B1, n=30; 40 mg/day famotidine in B2, n=30) and control group (group C: n=30). All patients received antiplatelet treatment including 300 mg/day aspirin and 300 mg/day clopidogrel as a loading dose, followed by 75 mg/day as a maintenance dose. Plasma CD62P and GP IIb/IIIa were measured by ELISA method and the platelet aggregation rate was measured by the impedance detection method. RESULTS: No significant difference was observed among groups at the reductions of CD62P, GPIIb/IIIa and PAgT before and after proton pump inhibitors or H2 receptor antagonist ingestion. When two subsets of group A or group B were compared with group C, no significant difference was seen at the reductions of CD62P, GPIIb/IIIa and PAgT. Between group A1 and A2, and between group B1 and B2, no statistical difference was found. CONCLUSION: Esomeprazole, rabeprazole, ranitidine or famotidine have no inhibitive effect on the antiplatelet activity of clopidogrel.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：2011-12-03.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:王艳,主治医师,硕士生 Email：wy7501@126. com
更新日期/Last Update: 2012-05-02