阿托伐他汀与氯吡格雷对急性冠状动脉综合征患者氯吡格雷羧酸代谢物血浓度的影响

Influence of atorvastatin on clopidogrel carboxylic acid metabolite blood levels in acute coronary syndrome patients taking clopidogrel

目的测定急性冠状动脉综合征(ACS)患者氯吡格雷羧酸代谢物血浓度,观察阿托伐他汀和氯吡格雷有无相互作用。方法对照组为25例健康受试者,ACS组为66例ACS患者。口服阿司匹林100mg/d和氯吡格雷75mg/d,并加阿托伐他汀20mg/d,自身前后对照。采用液相色谱串联质谱法测量氯吡格雷羧酸代谢物血浓度。结果对照组在双联抗血小板治疗加阿托伐他汀治疗和双联抗血小板治疗氯吡格雷羧酸代谢物血浓度分别为(5.76±0.87)ng/dL和(5.67±0.88)ng/dL,两者间差异无统计学意义(P=0.351)。ACS组在双联抗血小板治疗加阿托伐他汀治疗和双联抗血小板治疗氯吡格雷羧酸代谢物血浓度分别为(5.96±0.87)ng/dL和(5.86±0.97)ng/dL,两者间差异无统计学意义(P=0.115)。结论未检测到血氯吡格雷原药成分,氯吡格雷和阿托伐他汀未见相互作用。

Objective To determine plasma levels of clopidogrel earboxylic acid metabolite in patients with acute coronary artery syndrome who took atorvastatin and clopidogrel so as to evaluate the interaction between atorvastatin and elopidogrel. Methods The control group consisted of 25 healthy volunteers and the ACS group consisted of 66 patients with acute coronary artery syn drome. Both groups took aspirin 100 mg/d and clopidogrel 75 mg/d with atorvastatin 20 mg/d. Clopidogrel earboxylie acid metabo- lite was analyzed by high performance liquid chromatography coupled with tandem mass spectrometry. Results The control group of double antiplatelet therapy plus atorvastatin was compared to the control group of double antiplatelet therapy. Plasma levels of elopidogrel carboxylic acid metaholite were （ 5.76 ± 0.87） ng/dL and （ 5. 67 ± 0. 88） ng/dI., respectively. There was no significant difference（P=0. 351 ）. In ACS groups, double antiplatelet therapy plus atorvastatin therapy was compared to double antiplatelet therapy. Plasma levels of clopidogrel carboxylic acid metabolite for the two groups were（5.96 ±0.87）ng/dL and（5.86 ± 0.97）ng/ dL, respectively. There was no significant difference（P = 0. 115）, either. Conclusion Clopidogrel predecessor is not detected in plas- ma. There is no interaction between atorvastatin and clopidogrel.