不同剂量阿司匹林及氯吡格雷对冠心病患者阿司匹林抵抗的影响

The Effects of Different Doses of Aspirin and Clopidogrel in Patients with Coronary Artery Disease on Aspirin Resistance

目的观察不同剂量阿司匹林及氯吡格雷对冠心病阿司匹林抵抗(AR)患者血小板聚集功能的影响。方法筛选出冠心病患者中发生AR的患者90例,随机分为3组,分别给予口服阿司匹林100mg,300mg及氯吡格雷75mg+阿司匹林100mg治疗,4周后采用全血电阻法检测血小板聚集率。结果阿司匹林100mg和阿司匹林300mg组患者的血小板聚集率比较差异无统计学意义,而加用氯吡格雷组患者血小板聚集率明显降低(P<0.05)。结论加大阿司匹林剂量不能明显改善冠心病患者的AR,而加服氯吡格雷能有效抑制血小板聚集,减少患者AR的发生率,同时对AR患者应加强临床观察和护理干预。

Objective To observe the effects of different doses of aspirin and clopidogrel for the function pf platelet aggregation on patients with coronary heart disease and aspirin resistance （AR）. Method 90 cases of patients with coronary artery disease and AR were screened, randomly divided into three groups and respectively given oral aspirin 100 mg, 300 mg and clopidogrel 75 mg plus aspirin100 mg. After four weeks, the rates of platelet aggregation were tested with the whole blood resistance method. Results The rates of platelet aggregation in groups treated with aspirin 100 mg and 300 mg had no significant difference, but the rate of platelet aggregation in the group given aspirin plus clopidogrel was significantly lower （P〈0.05）. Conclusion AR in patients with coronary artery disease can not be significantly improved by increasing the dose of aspirin, but aspirin plus clopidogrel can effectively inhibit platelet aggregation and reduce the incidence of AR. Clinical observation and nursing intervention for AR patients should be strengthened.