[1]陈瑞阳.双倍剂量氯吡格雷对心肌梗死患者经皮冠状动脉介入术后氯吡格雷抵抗的影响[J].新乡医学院学报,2018,35(8):716-718.[doi:10.7683/xxyxyxb.2018.08.017]
　CHEN Rui-yang.Effect of double dose of clopidogrel on clopidogrel resistance after percutaneous coronary intervention in patients with myocardial infarction[J].Journal of Xinxiang Medical University,2018,35(8):716-718.[doi:10.7683/xxyxyxb.2018.08.017]
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双倍剂量氯吡格雷对心肌梗死患者经皮冠状动脉介入术后氯吡格雷抵抗的影响
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
35
期数:
2018年8
页码:
716-718
栏目:
临床研究
出版日期:
2018-08-05

文章信息/Info

Title:
Effect of double dose of clopidogrel on clopidogrel resistance after percutaneous coronary intervention in patients with myocardial infarction
作者:
陈瑞阳
（长垣县人民医院心内科，河南　长垣　453400）
Author(s):
CHEN Rui-yang
（Department of Cardiology，the People′s Hospital of Changyuan County，Changyuan 453400，Henan Province，China）
关键词:
心肌梗死; 经皮冠状动脉介入术; 氯吡格雷抵抗; 氯吡格雷
Keywords:
myocardial infarction; percutaneous coronary intervention; clopidogrel resistance; clopidogrel
分类号:
R541.4
DOI:
10.7683/xxyxyxb.2018.08.017
文献标志码:
A
摘要:
目的　探讨双倍剂量氯吡格雷对心肌梗死患者药物洗脱支架经皮冠状动脉介入（PCI）术后氯吡格雷抵抗的影响。方法　将2010年6月至2017年6月长垣县人民医院收治的138例PCI术后氯吡格雷抵抗患者分为对照组和观察组，每组69例。2组患者术前均给予阿司匹林300 mg·d-1，服用1个月后改为100 mg·d-1，长期口服。对照组患者入院第2天起口服氯吡格雷75 mg·d-1，观察组患者入院第2天起口服氯吡格雷150 mg·d-1，服用1个月后改为75 mg·d-1，均长期维持治疗。比较2组患者治疗前、治疗7 d及1、3、6个月后二磷酸腺苷（ADP）诱导的血小板抑制率、术后6个月心血管事件和出血事件发生率。结果　治疗前2组患者ADP诱导的血小板抑制率比较差异无统计学意义（P>0.05）；治疗后7 d及1、3、6个月观察组患者ADP诱导的血小板抑制率均高于对照组（P<0.05）。术后6个月，观察组与对照组患者心血管事件发生率分别为11.59％（8/69）和26.08％（18/69），观察组患者心血管事件发生率低于对照组（χ2=5.629，P<0.05）；观察组和对照组患者出血事件发生率分别为11.59％（8/69）和14.49％（10/69），2组患者出血事件发生率比较差异无统计学意义（χ2=1.653，P>0.05）。结论　双倍剂量氯吡格雷能够有效降低心肌梗死PCI后氯吡格雷抵抗患者ADP诱导的血小板抑制率和心血管事件发生率。
Abstract:
Objective　To investigate the effect of double-dose clopidogrel on clopidogrel resistance after percutaneous coronary intervention （PCI） with drug eluting stent in patients with myocardial infarction.Methods　One hundred and thirty eight patients with clopidogrel resistance after PCI in the People′s Hospital of Changyuan County from June 2010 to June 2017 were selected as the study subjects.All the patients were divided into control group and observation group，with 69 cases in each group.The patients in the two groups were received 300 mg·d-1 aspirin before surgery，and the dose was changed to 100 mg·d-1 after one month of administration.The patients in the control group were received oral administration of 75 mg·d-1 clopidogrel from the second day after admission.The patients in the observation group were received oral administration of 150 mg·d-1 clopidogrel from the second day after admission，and the dose was changed to 75 mg·d-1 after one month.All the drugs were given for longperiods of time.The adenosine diphosphate （ADP） induced platelet inhibition rate was compared between the two groups before treatment and at seven days and one，three，six months after treatment.The incidence of cardiovascular events and bleeding events at 6 months after surgery were compared between the two groups.Results　There was no significant difference in the ADP induced platelet inhibition rate between the two groups before treatment （P>0.05）.The ADP induced platelet inhibition rate of the observation group was higher than that of the control group at seven days and one，three，six months after treatment （P<0.05）.The incidence of cardiovascular events in the observation group and the control group at six months after operation was 11.59％（8/69） and 26.08％（18/69），respectively.The incidence of cardiovascular events in the observation group was lower than that in the control group at six months after operation（χ2=5.629，P<0.05）.The incidence of bleeding events in the observation group and the control group at six months after operation was 11.59％（8/69）and 14.49％（10/69），respectively.There was no significant difference in the incidence of bleeding events between the two groups at six months after operation （χ2=1.653，P>0.05）.Conclusion　Double dose of clopidogrel can effectively reduce the ADP induced platelet inhibition rate and the incidence of cardiovascular events in patients with clopidogrel resistance after myocardial infarction.

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更新日期/Last Update: 2018-08-05