不同剂量氯吡格雷对经皮冠状动脉介入治疗的冠状动脉左主干病变患者的疗效与安全性  

Efficacy and safety of different doses of clopidogrel therapy in patients with left main coronary artery disease undergoing percutaneous coronary intervention

作　　者：王梅[1] 艾辉[1] 王春梅[1] 祖晓麟[1] 王成钢[1] 朱小玲[1] 

机构地区：[1]首都医科大学附属北京安贞医院抢救中心,北京100029

出　　处：《药物不良反应杂志》2011年第3期157-160,共4页Adverse Drug Reactions Journal

摘　　要：目的：评价不同剂量氯吡格雷对经皮冠状动脉介入治疗（PCI）的冠状动脉左主干病变患者的近期疗效和安全性。方法：2006年1月至2010年1月因冠状动脉左主干病变（左主干狭窄〉75％）在北京安贞医院抢救中心接受PCI、年龄≤75岁的患者为研究对象，收集其临床资料进行回顾性分析。根据服用氯吡格雷剂量将患者分为75mg剂量组（PCI治疗后第1～30天口服氯吡格雷75mg／d）和150mg剂量组（PCI治疗后第1～30天口服氯吡格雷150mg／d）。记录2组患者PCI治疗前和治疗后1、7、14、30d血小板最大聚集率和最大聚集时间，观察2组患者住院期间不良反应的发生情况。结果：共120例PCI治疗后住院患者纳入研究。其中，75mg剂量组男性46例，女性18例，平均年龄（55±7）岁；150mg剂量组男性35例，女性21例，平均年龄（50±8）岁。PCI治疗前和治疗后1、7、14、30d血小板最大聚集率和最大聚集时间，75mg剂量组分别为84％±18％和（240±48）s、81％±14％和（238±44）s、59％±12％和（210±42）s、48％±10％和（199±40）s、43％±10％和（184±30）s，150nag剂量组分别为86％=16％和（244±46）s、77％±16％和（239±46）s、51％±11％和（180±41）s、40％土10％和（166±33）s、38％±9％和（159±35）s，治疗后2组患者血小板最大聚集率和最大聚集时间均呈下降趋势，但150mg剂量组这2项指标均低于75mg剂量组（均P〈0．01）。2组2项指标治疗后7、14、30d分别与治疗前、治疗后1d相比差异均有统计学意义（均P〈0．05）；2组血小板最大聚集率治疗后14、30d与治疗后7d相比差异有统计学意义（P〈0．05）；150mg剂量组血小板最大聚集率治疗后1d与治疗前相比差异有统计学意义（均P〈0．05）。2组患者均未出现严重出血、再发心肌梗死、中风等心血管事件。轻微出血和腹痛、消化不良、便秘、皮疹、头晕、头痛等�Objective： To evaluate the short-term efficacy and safety of different doses of elopidogrel therapy in patients with left main coronary artery disease undergoing pereutaneous coronary intervention （PCI）. Methods： The ~〈 75-year-old patients with left main coronary artery disease （a 〉75% steaosis in the left main stem） undergoing PCI were hospitalized in Emergency Department of Beijing Anzhen Hospital from January 20136 to January 2010 and served as the subjects. All clinical data from the subjects were collected and retrospective analysis was conducted. Patients were divided into the 75 mg dose group （ oral administration of 75 mg/d on days 1-30 after PCI） and the 150 mE dose group （oral administration of 150 mg/d on days 1-30 after PCI） according to the doses of elopidogrel use. Maximal platelet aggregation rate and time was measured and recorded before PCI and 1,7, 14 and 30 days after PCI, and adverse events were observed during haspitalization. Results： A total of 120 hospitalized patients undergoing PCI were enrolled in this study. Of them, 46 were male and 18 were female with mean age of （52 ± 7 ） years in the 75 mg dose group and 35 were male and 21 were female with mean age of （50 ±8） years in the 150 mg dose group. The maximal platelet aggregation rates and time before PCI and 1, 7, 14, 30 days after PCI were 84% ± 18% and （240 ± 48） s. 81% ± 14% and（238±44） s. 59% ± 12% and （210 ± 42） s.48% ± 10% and （ 199 ± 40）s, 43% ± 10% and （ 184 ± 30） s in the 75 mg dose group, and 86% ± 16% and （244 ± 46） s, 77% ± 16% and （239±46）s, 51% ±11% and （180±41）s, 40% ±10% and （166±33）s, 38% ±9% and （159±35）s in the 150 mg dose group. The results of maximal platelet aggregation rate and time showed a decreasing trend after PCI in both groups and the values of the 2 indexes in the 150 mg dose group were lower than those in the 75 mg dose group （all P 〈0.01）. In a comparison of the two platelet aggregation index values 7, 1

关 键 词：氯吡格雷 左主干病变 经皮冠状动脉腔内介入治疗 

分 类 号：R973.2[医药卫生—药品] R541.4[医药卫生—药学]