冠心病患者氯吡格雷低反应性的研究

Clopidogrel Low-Responsiveness in Patients with Coronary Artery Disease

目的:探讨冠心病患者氯吡格雷低反应性(Clopidogrel low-responsive-ness,CLR)的发生率,并分析其临床特征。方法:选择90例入住我院的急性冠脉综合征患者,其中有27例行经皮冠状动脉介入治疗(PCI),所有入选患者均给予氯吡格雷负荷剂量300 mg及维持量75 mg/d,于服用氯吡格雷前及服用氯吡格雷后7 d测定5μmol/L二磷酸腺苷(adenosine diphosphate,ADP)诱导的血小板聚集率,并计算血小板聚集抑制率(△A)。根据△A分为氯吡格雷低反应组和氯吡格雷正常反应组。结果:氯吡格雷低反应的发生率为24.4%。低反应组与正常反应组比较发现总胆固醇(total cholesterol,TC)、体重指数(body mass in-dex,BMI)、合并糖尿病及置入支架患者中差异有统计学意义。结论:CLR现象可能与TC、BMI、是否有糖尿病、是否置入支架等因素有关。

Objective： To investigate clopidogrel tow- responsiveness（ CLR） in the patients with coronary artery disease , and further to evaluate the clinical characteristics of them. Methods： We prospectively enrolled 90 patients with acute coronary syndrome（ACS）, of the total there are twentyseven patients who had undergone percutaneous coronary interventional（PCI） therapy. All patients were received a loading dose of 300 mg clopidogrel followed by a maintenance dose of 75 mg/d. Platelet aggregation ratio induced by adenosine diphosphate （ADP） with a concentration of 5 μmol/L was measured before and 7 days after clopidogrel intake, and the inhibition of platelet aggregation ratio（AA） was calculated, patients were divided into clopidogrel low- responsiveness group and clopidogrel normal- responsiveness group. Results：Of 90 patients, 24.4 % were CLR. The clin- ical characteristics of clopidogrel low - responsiveness patients compared with clopidogrel normal - responsiveness patients Total Cholesterol（TC）,Body Mass Index （BMI）, diabetic and percutaneous coronary interventional patients were predominant. Conclusion： Clopidogrel low- response is likely correlated with some clinical such as TC,BMI,diabetic and PCI.