氯吡格雷在冠心病患者中对阿托伐他汀降脂的影响

Effect of clopidogrel on lipid lowering of atorvastatin in coronary artery disease

目的:研究氯吡格雷在冠心病中对不同剂量阿托伐他汀降低血脂幅度方面的影响。方法:126位冠心病患者,入院后随机服用阿托伐他汀10 mg/d和20 mg/d,其中入院后行PCI治疗者同时服用氯吡格雷,稳定型心绞痛未行PCI治疗者不服用氯吡格雷,按服用阿托伐他汀剂量和氯吡格雷分为四组,A组为阿托伐他汀10 mg/d+氯吡格雷,共43例,B组为阿托伐他汀20 mg/d+氯吡格雷,共29例,C组为单用阿托伐他汀10 mg/d,共37例,D组为单用阿托伐他汀20 mg/d,共17例,分别在入院24 h内和服用氯吡格雷后1个月测定患者血脂,比较A组和C组,B组和D组患者血脂变化幅度。结果:治疗1个月后A组和C组、B组和D组血脂,包括总胆固醇,甘油三脂,LDL-C,HDL-C,ApoA,ApoB,Lpa下降幅度差异无统计学意义(P>0.05)。结论:治疗1个月后氯吡格雷对阿托伐他汀在降脂方面的作用无影响。

Objective To investigate the effect of clopidogrel on lipid lowering of atorvastatin in coronary artery disease. Methods One hundred and twenty-six patients with coronary artery disease received atorvastatin 10 mg/d and 20 mg/d randomly. Those undergoing successful percutaneous coronary intervention received clopidogrel and separated into two groups, group A （43 patients receiving atorvastatin 10 mg/d plus clopidogrel） and group B （29 patients receiving atorvastatin 20 mg/d plus clopidogrel）. Those with stable angina pectoris without undergoing percutaneous coronary intervention did not receive clopidogrel and divided into two groups, group C （37 patients receiving alone atorvastatin 10 mg/d） and group D （17 patients receiving atorvastatin 20 mg/d）. The serum levels of plasma lipid were determined with biochemistry assay in 24 hours after admission and 1 month after clopidogrel therapy. The difference of plasma lipid was compared between group A and group C, group B and group D. Results There was no statistic difference in the changes of blood lipid, including TC, TG, LDL-C, HDL-C, ApoA, ApoB and Lpa between group A and C, group B and D in 1 month after treatment（P〉0. 05）. Conclusion The effect of clopidogrel therapy on the extent of lipid lowering of atorvastatin is not evident in 1 month after treatment.