质子泵抑制剂埃索美拉唑对氯吡格雷抗血小板作用的影响

摘要

目的 观察质子泵抑制剂埃索美拉唑是否影响氯吡格雷的抗血小板聚集作用.方法 选择不稳定性心绞痛患者118例,于入院即刻行血小板聚集率测定;患者接受100 mg/d阿司匹林和75 mg/d氯吡格雷治疗7 d后,再次测定血小板聚集率,根据结果将患者分为有效反应组87例和低反应组31例;有效反应组再随机分为2个亚组,给予埃索美拉唑20 mg/d(治疗组,44例)和安慰荆20 mg/d(安慰剂组,43例).30 d后,再次测定全部患者的血小板聚集率,比较用药前后备组血小板聚集率的变化.结果 与有效反应组比较,低反应组体重指数、糖尿病及吸烟比例明显升高(P＜0.05).治疗组和安慰剂组治疗前后的血小板聚集率无明显差异;低反应组服药前后的血小板聚集率也无明显差异(P＞0.05).结论 未发现埃索美拉唑对氯吡格雷的抗血小板聚集作用产生明显影响.%Objective To observe the influence of proton pump inhibitor(PPI) esomeprazole on anti-platelet effect of clopidogrel.Methods The first platelet aggregation test(PAT) was immediately done when 118 patients with unstable angina pectoris were admitted to hospital.The second PAT was done after 7 days of treatment with aspirin(100 mg/d) and clopidogrel(75 mg/d).The patients were divided into efficacious response group and low response group according to the inhibition of platelet aggregation.The patients in efficacious response group were randomly divided into accepting esomeprazole(G1) or placebo(G2) subgroups.The patients in low response group were given esomeprazole(G3).The third PAT was done after 30 days.The difference of platelet aggregation was compared between the G1 and G2 groups and platelet aggregation was analyzed after taking esomeprazole in G3 group.Results There was no significant difference of platelet aggregation rate in the G1 and G2 before and after 30 d treatment.There was no significant difference of platelet aggregation rate in the G3 before and after treatment.Conclusion The PPI esomeprazole has no significant influence on inhibition of platelet aggregation by clopidogrel.