急性冠状动脉综合征氯吡格雷抵抗患者换用替格瑞洛后的PAR变化

The changes of platelet aggregation ratio in acute coronary syndrome patients with clopigogrel resistance following alternated by ticagrelor

目的探讨急性冠状动脉综合征(ACS)氯吡格雷抵抗患者换用替格瑞洛后血小板聚集率(PAR)的变化情况。方法急性冠状动脉综合征患者,经皮冠状动脉介入治疗(PCI)术后测定二磷酸腺苷(ADP)诱导血小板聚集率,根据血小板聚集率筛选出氯吡格雷抵抗患者57例,男45例,年龄(62.98±10.51)岁,体重指数(24.53±2.53)kg/m2;女12例,年龄(64.17±5.84)岁,体重指数(25.49±3.37)kg/m2。氯吡格雷抵抗患者将氯吡格雷75 mg,1次/d更换为替格瑞洛负荷量180 mg,次日开始90 mg,2次/d。随访30 d,应用替格瑞洛后7、15、30 d检测血小板聚集率。结果服用替格瑞洛后血小板聚集率明显降低,与应用氯吡格雷后血小板聚集率的差异有显著统计学意义(P<0.05),患者吸烟,是否合并高血压或糖尿病及服用降压、降糖药物,其血小板聚集率下降程度之间的差异无统计学意义(P>0.05)。结论替格瑞洛能够显著降低氯吡格雷抵抗ACS患者ADP诱导的血小板聚集率。

Objective To observe the variance of the platelet aggregation ratio after using ticagrelor for instead of clopidogrel in acute coronary syndrome patients suffering from clopidogrel resistance,Methods Platelet aggregation ratio test induced by adenosine diphosphate(ADP) identified acute coronary syndrome patients with clopidogrel resistance underwent the PCI(percutaneous coronary intervention) from July 2013 to July 2014,The 57 patients with clopidogrel resistance were given 180 mg ticagrelor load followed by 90 mg twice daily maintenance therapy,for instead of clopidogrel 75 mg once daily for 1 month,and the platelet aggregation ratio were tested.Results Platelet aggregation rate had significant difference(P<0.05) statistically after administration of ticagrelor compared with clopidogrel,Conclusion Compared with the regular-dose treatment of clopidogrel,ticagrel can effectively decrease the platelet aggregation ratio in acute coronary syndrome patients with clopidogrel resistance.