不同剂量氯吡格雷联合阿司匹林对 U AP 患者血小板相关指标及安全性的影响

摘要

Objective :To explore influence of different doses of clopidogrel combined aspirin on platelet related inde—xes and safety in patients with unstable angina pectoris (UAP).Methods : A total of 92 UAP patients treated in our hospital were randomly and equally divided into large dose clopidogrel combined group (received 150mg／d clopi—dogrel combined aspirin ) and routine dose clopidogrel combined group (received 75mg／d clopidogrel combined aspi—rin) ,both groups were continuously treated for three months .Therapeutic effect , medication safety , level of thrombolytic granule membrane protein (GMP)—140 ,maximum platelet aggregation rate (LTA—PAmax ) and ADP—induced maximum platelet amplitude (MAADP ) were compared between two groups .Results : After three—month treatment ,there were no significant difference in total effective rate ,incidence rate of major adverse cardiovascular events ,GMP—140 level ,LTA—PAmax and MAADP between two groups , P＞0. 05 all.Incidence rate of severe hemor—rhage in large dose clopidogrel group was higher than that of routine dose group (6.52% vs.2. 17%) without signifi—cant difference ( P＝0.609).Conclusion : Increased dose of clopidogrel combined aspirin doesn＇t obtain significant therapeutic effect ,but may be risk of hemorrhage for unstable angina pectoris ,which calls for clinical attention%目的:探讨不同剂量氯吡格雷与阿司匹林治疗对不稳定型心绞痛(UAP)患者血小板相关指标及安全性的影响.方法:我院收治的UAP患者92例被随机均分为氯吡格雷大剂量联合组(150mg／d氯吡格雷联合阿司匹林)和氯吡格雷常规剂量联合组(75mg／d氯吡格雷联合阿司匹林) .持续治疗3个月,比较两组临床疗效,用药安全性、血小板颗粒膜蛋白(GMP )—140水平及以血小板最大聚集率(LTA—PAmax ) 、 ADP诱导的血小板最大振幅(MAADP )等的差异.结果:治疗 3 个月后,两组患者治疗总有效率、主要不良心血管事件、 GMP—140 水平、LTA—PAmax和MAADP等比较均无显著差异( P均＞ 0.05 ) .氯吡格雷大剂量组严重出血发生率高于常规剂量组(6.52% 比2.17%) ,差异不显著(P＝0.609).结论:对于不稳定型心绞痛,氯吡格雷增加剂量并未增加疗效,且可能增加严重出血,值得临床重视.