替格瑞洛对氯吡格雷低反应患者血小板聚集率的影响

摘要

目的：探讨替格瑞洛对氯吡格雷低反应患者血小板聚集率（PAR）的影响。方法接受经皮冠状动脉介入术（PCI）冠心病患者予口服阿司匹林100 mg／d＋氯吡格雷75 mg／d后，均经光学比浊法证实存在氯吡格雷低反应[以二磷酸腺苷诱导的PAR（PLADP ）＞40％）]的52例均分为A组（口服氯吡格雷75 mg／d）和B组（口服替格瑞洛90 mg ，每日2次）。两组均继续服用阿司匹林100 mg／d；1个月后复查PAR。结果 A、B组治疗前和治疗1个月后花生四烯酸诱导的PAR比较均无统计学差异（P＞0．05）。治疗前，A、B组PLADP相仿[（52.46±7.12）％ vs ．（53.42±7.27）％]（P＞0．05）；治疗后，B组PLADP低于A组[（20.08±12.38）％ vs ．（49.96±9.52）％]和治疗前（ P＜0．01）。结论对于PCI术后氯吡格雷低反应患者，更换替格瑞洛治疗能显著降低PAR。%Objective To investigate the effect of ticagrelor on platelet aggregation rate(PAR) of the patients with low response to clopidogrel(CLR) .Methods After orally taking aspirin 100 mg per day plus clopidogrel 75 mg per day ,52 patients with coronary heart disease underwent percutaneous coronary intervention (PCI ) were comfirmed to be CLR by light transmittance aggregometry [adenosine diphosphate‐induced PAR(PLADP )>40% ] ,who were equally divided into two groups of A (oral aspirin 100 mg and clopidogrel 75 mg per day ) and B (oral aspirin 100 mg per day plus ticagrelor 90 mg twice a day) .The PAR was reexamined one month after treatment in both groups . Results There were no significant differences between two groups in arachidonic acid‐induced PAR before and after treatment(P>0 .05) .Before treatment ,PLADP in groups of A and B were similar [(52.46 ± 7.12)% vs .(53.42 ± 7.27)% ](P>0 .05) .But PLADP after treatment in group B was lower than that in group A[(20.08 ± 12.38)% vs .(49.96 ± 9.52)% ](P<0 .01) .Conclusion In the patients with CLR after PCI ,use of ticagrelor instead of clopidogrel can significantly reduce PAR .