【摘要】 目的观察埃索美拉唑对氯吡格雷血小板抑制作用的影响。方法 151例接受经皮冠脉介入治疗的冠状动脉疾病患者,均接受氯吡格雷负荷量600 mg治疗,在进入研究时,患者已经平均接受了3个月(至少5 d)的氯吡格雷(75 mg.d-1)和阿司匹林(100 mg.d-1)治疗。其中76例在此基础上给予埃索美拉唑(20 mg,bid)治疗,作为实验组;另外75例作为对照组。结果血小板反应指数在实验组(n=76,总体均数51%,范围48%～54%)和对照组(n=75,总体均数49%,范围43%～55%;P=0.718)的患者中几乎完全相同。埃索美拉唑(n=76;PRI=54%;聚集度42 U)和对照组(n=75;PRI=49%;聚集度=41 U;P=0.373)的患者之间,PRI或者二磷酸腺苷诱导的血小板聚集度没有差异。结论对于接受氯吡格雷治疗且同时需要抑酸干预的患者,需要质子泵抑制剂(PPI)治疗时,应尽可能的选择相互作用影响小的埃索美拉唑。更多还原

【Abstract】 Objective To investigate the effect of esomeprazole on platelet inhibition induced by clopidogrel.Methods Response to clopidogrel was assessed by the vasodilator-agent stimulated phosphoprotein(VASP) assay and aggregometry(multiplate analyzer) in 151 patients with coronary artery disease(CAD) undergoing percutaneous coronary intervention(PCI).All patients received a clopidogrel loading dose(600 mg) at the start of clopidogrel treatment.Patients had been treated with clopidogrel(75 mg·d-1) and aspirin(100 mg·d-1) for 3 months on average(5 days at least).Esomeprazole was used in the study.Results The mean platelet reactivity index(PRI,assessed by the VAS Passay)was nearly the same in patients with esomeprazole(n=76;PRI = 54%) or in the control group(n=75;PRI = 49%;P=0.718).There was no difference in the PRI or the adenosine diphosphate-induced platelet aggregation between patients with esomeprazole(n=76;PRI=54%;aggregation=42 U),or patients without PPI(n=75;PRI=49%;aggregation=41 U;P=0.373).Conclusion Doctors had better choose esomeprazole with a small interaction to treat patients who received clopidogrel therapy and acid suppression intervention when needing PPI treatment.更多还原