不同维持剂量氯吡格雷对择期经皮冠脉介入治疗患者术后血小板聚集率的影响

Effect of different doses of Clopidogrel on platelet aggregation rate in the patients with percutaneous coronary intervention

目的探讨不同维持剂量氯吡格雷对择期经皮冠脉介入治疗(PCI)患者血小板聚集率的影响及其临床意义。方法随机双盲将118例择期PCI患者分为A、B两组,术前600mg负荷剂量相同,术后第1天开始分别给予不同剂量氯吡格雷(波立维、法国赛诺菲—安万特公司生产)75mg/d或150mg/d,于术前及术后1天、7天、14天和30天评估血小板聚集率。结果A、B两组患者术前和术后1天ADP诱导的血小板聚集率和最大聚集时间比较无显著性差异,而术后7天、14天、30天比较差异有显著性。结论较高剂量的氯吡格雷可以降低择期PCI患者的血小板聚集功能。

Objective To investigate the platelet aggregation effects with different doses of clopidogrel in the patients after percutaneous coronary intervention（PCI）.Methods Blood samples obtained from 118 patients after PCI were randomized to double-blind treatment with clopidogrel 600mg loading dose（LD）,group A（n=60）with clopidogrel 75mg maintance dose（MD）and group B（n=58）with clopidogrel 150mg maintenance dose（MD）.Maximal platelet aggregation rate was measured before PCI and after 1,7,14 and 30 days of PCI.Results There were no significant differences in max% induced by ADP between two groups before PCI and 1 day after PCI,whereas there were significantly decreased platelet aggregation rate in group B（P〈0.01）at 7,14 and 30 days after PCI.Conclusion This finding proved that a dose of clopidogrel（150 mg/d）can improve platelet aggregation function in patients after PCI.