本文選題：氯吡格雷 + 替格瑞洛��； 參考：《中風(fēng)與神經(jīng)疾病雜志》2017年10期

【摘要】：目的探討用血栓彈力圖評價符合雙抗治療的缺血性腦血管病患者,因氯吡格雷低反應(yīng)性,改為高維持劑量及改服替格瑞洛后血小板抑制率的變化。方法選擇符合雙抗治療的缺血性腦血管病患者聯(lián)合應(yīng)用抗血小板制劑(阿司匹林腸溶片100 mg/qd+氯吡格雷75 mg/qd)前及后7 d,用血栓彈力圖檢測患者的花生四烯酸(AA)和二磷酸腺苷(ADP)途徑誘導(dǎo)的血小板抑制率,篩選出氯吡格雷低反應(yīng)性者96例,隨機(jī)分為3組,常規(guī)劑量組(氯吡格雷75 mg/qd,32例)、高維持量組(氯吡格雷150 mg/qd,32例)和替格瑞洛組(替格瑞洛90 mg/bid,32例),3組阿司匹林繼續(xù)按原劑量服用。分組后3組按新方案治療7 d,再次復(fù)查血栓彈力圖。結(jié)果分組后高維持量組及替格瑞洛組ADP誘導(dǎo)的血小板抑制率較常規(guī)劑量組有顯著性差異(P0.05),3組均未發(fā)生出血等嚴(yán)重不良事件,替格瑞洛組發(fā)生1例輕度呼吸困難。替格瑞洛組高于同一時間點高維持量組ADP途徑誘導(dǎo)的血小板抑制率(P0.05)。結(jié)論針對常規(guī)劑量氯吡格雷的低反應(yīng)性,替格瑞洛及雙倍劑量的氯吡格雷均能有效降低血小板的高反應(yīng)性,并且替格瑞洛的作用更為明顯,且未增加出血等不良事件的發(fā)生。
[Abstract]:Objective to investigate the changes of platelet inhibition rate in patients with ischemic cerebrovascular disease treated with thromboelastography due to low reactivity of clopidogrel to high maintenance dose and tigride. Methods Ischemic cerebrovascular disease patients who were in accordance with double antibody therapy were selected to be treated with antiplatelet preparation (aspirin enteric-coated tablet 100 mg/qd clopidogrel 75 mg / qd) before and 7 days after treatment. Thromboelastography was used to detect arachidonic acid (AA) and diethylenoic acid (AA) in patients with ischemic cerebrovascular disease. Platelet inhibition rate induced by adenosine phosphate (ADP) pathway, 96 cases of clopidogrel hyporeactivity were selected and randomly divided into 3 groups. The routine dose group (clopidogrel 75 mg / qdU 32 cases), high maintenance group (clopidogrel 150 mg / qdU 32 cases) and tigrilol group (90 mg / kg tigride 32 cases) continued to take aspirin according to the original dose. After the 3 groups were treated with the new regimen for 7 days, the thromboelastogram was reexamined again. Results the platelet inhibition rate induced by ADP in the high maintenance dose group and tigrilol group was significantly higher than that in the routine dose group. There were no severe adverse events such as hemorrhage in the three groups, while one case in the tigrillo group had mild dyspnea. The platelet inhibition rate induced by ADP pathway in tigrilol group was higher than that in high maintenance group at the same time point (P 0.05). Conclusion both tigrilol and double dose clopidogrel can reduce platelet hyperreactivity effectively in allusion to the low reactivity of clopidogrel at conventional dose, and the effect of tigrilol is more obvious, and the occurrence of adverse events such as hemorrhage is not increased.
【作者單位】： 北京航天中心醫(yī)院神經(jīng)內(nèi)科;
【分類號】：R743.3

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本文編號：1861021