上消化道出血高危患者经皮冠状动脉介入术后应用西洛他唑氯吡格雷联合治疗对血小板膜糖蛋白的影响  

Effection of Cilostazol Combinated with Clopidogrel on Platelet Membrane Glycoprotein in Patients with Coronary Heart Disease and High Risk Factors of Upper Digestive Tract Hemorrhage after Percutaneous Coronary Intervention

作　　者：李彪[1] 吴同果[1] 赵强[1] 黎庆梅[1] 韦建瑞[1] 

机构地区：[1]暨南大学第四附属医院,广州市红十字会医院心血管内科,广东广州510220

出　　处：《今日药学》2014年第1期1-3,共3页Pharmacy Today

基　　金：2010年广东省科技计划项目(编号:00315511120209020);2011年广州市医药卫生科技项目(编号:201102A213201)

摘　　要：目的观察合并上消化道出血(UGH)高危因素的冠心病患者经皮冠状动脉介入治疗(PCI)后应用西洛他唑联合氯吡格雷治疗对血小板活化的抑制效果、安全的影响。方法 125例冠心病合并UGH高危因素PCI术后的患者分为:A组(n=62):口服西洛他唑100 mg Bid+氯吡格雷75 mg Qd;B组(n=63):口服阿司匹林100 mg Qd+氯吡格雷75 mg Qd。利用流式细胞术分别检测和比较2组治疗第7、14天纤维蛋白原受体(PAC-1)和P选择素(CD62P)抑制率,记录主要不良心脏事件(MACE),出血、消化道事件。结果 2组在同时间点对PAC-1、CD62P抑制率、MACE无统计学差异;A组的出血并发症、消化道事件显著少于B组(P<0.05)。结论合并UGH高危因素的冠心病患者PCI术后应用西洛他唑联合氯吡格雷治疗对血小板活化抑制效果好,安全性好。Objective To evaluate the efficacy and safety of cilostazol combined with clopidogrel in patients with coronary heart disease and high risk factors of upper digestive tract hemorrhage （UGH） after percutaneous coronary intervention （PCI）. Methods A total of 125 patients with coronary heart disease and risk factors of UGH after PCI were randomly divided into 2 groups. Patients in Group A （n = 62） received cilostazol （100 mg Bid） plus clopidogrel （75 mg Qd）, and patients in Group B （n =63 ） received aspirin （100 mg Qd） plus clopidogrel （75 mg Qd）. The inhibition rates of PAC-1 and CD62P were measured by flow cytometry at 7th and 14th day after initial therapy. The major adverse cardiac event （MACE）, gastrointestinal events and bleeding complications were monitored. Results MACE and the inhibition rate of （PAC-1, CD62P） had no significant difference between 2 groups in the same time point. Compared with Group B, hemorrhage complications, gastrointestinal events in Group A decreased significantly （ P 〈 0.05 ）. Conclusion For patients with coronary heart disease and high risk factors of UGH after PCI, antiplatelet treatment with cilostazol plus clopidogrel is efficient and safe.

关 键 词：西洛他唑 流式细胞术 血小板膜糖蛋白 

分 类 号：R97[医药卫生—药品]