阿托伐他汀对氯吡格雷抗血小板活性影响的研究

Impact of atorvastatin on the antiplatelet activity of clopidogrel in patients with acute coronary syndromes

目的:观察阿托伐他汀对氯吡格雷抗血小板活性的影响。方法:29例急性冠脉综合征(ACS)病人被随机分入阿托伐他汀组(n=10)、普伐他汀组(n=9)和对照组(n=10),每组病人均接受阿斯匹林(ASA)、氯吡格雷和低分子量肝素(LMWH)治疗。采用流式细胞仪检测血小板活化指标。结果:治疗3d后,三组血小板活化指标PAC-1和CD62P较治疗前均明显降低,P均<0.05;各组上述两个指标的下降值两两比较均无明显差异,P均>0.05。结论:经细胞色素P4503A4(CYP3A4)途径代谢的阿托伐他汀不抑制氯吡格雷的抗血小板活性。

Objective： To investigate whether the coadministration of atorvastatin for 3 days in patients with acute coronary syndromes （ACS） could affect the antiplatelet potency of clopidogrel. Methods： Continuous 29 patients who were diagnosed as ACS were assigned randomly to atorvastatin therapy group （n=10）, pravastatin therapy group （n= 9） and controlled group （n= 10）. Every patient received aspirin, clopidogrel and low molecular weigh heparin. Platelet activation parameters were measured by flow cytometry. Results： After treatment activated platelet markers （PAC-1 and CD62P） were reduced significantly in three groups （P〈0. 05 all） ; the reductions of the PAC-1 and CD 62P in three groups were similar （P〉0. 05 all）. Conclusion： Atorvastatin, which is metabolited through the cytochrome P450 （CYP） 3A4 Pathway, does not inhibits the antiplatelet activity of clopidogrel.