探索他汀类药物治疗急性短暂性脑缺血发作对氯吡格雷血小板作用抑制率影响  

To Explore the Effect of Statins in the Treatment of Acute Transient Ischemic Attack on Clopidogrel Platelet Inhibition Rate

作　　者：周俊英[1] 

机构地区：[1]濮阳市人民医院神经内科,河南濮阳457000

出　　处：《中国继续医学教育》2016年第20期138-139,共2页China Continuing Medical Education

摘　　要：目的探讨他汀类药物与氯吡格雷联合在急性短暂性脑缺血发作患者中,对氯吡格雷血小板抑制率的影响。方法选择首次诊断急性短暂性脑缺血发作(TIA)患57例,随机分A、B、C组,每组19例,A组给予10 mg/次瑞舒伐他汀,口服,1次/d,B组给予20mg/次阿托伐他汀,口服,1次/d,C组安慰剂对照;给予氯吡格雷75 mg/次,口服,1次/d;其他基础治疗均相同;采用血栓弹力图(Thrombelastography,TEG)检测5 d后血小板抑制率,检测指标包括:检测反应时间、凝固时间、凝固角、最大凝固振幅等参数指标。结果A组血小板抑制率为(53.4±7.2)%,B组血小板抑制率为(46.5±6.8)%,C组血小板抑制率为(56.7±5.9)%,A组和B组与C组相比,P<0.05,具有统计学差异;A组和B组相比,P<0.05,具有统计学差异。结论他汀类药物与氯吡格雷联合应用会降低氯吡格雷的血小板抑制率,不同他汀同时存在差异性,瑞舒伐他汀相较阿托伐他汀对氯吡格雷血小板抑制作用影响小。Objective To investigate the effects of statins and clopidogrel on the platelet inhibition rate of clopidogrel in patients with acute transient ischemic attack. Methods Select first diagnosed acute transient ischemic attack （TIA） suffering from 57 cases, were randomly divided into A, B, C group, 19 cases in each group, a group give 10 mg / time of rosuvastatin, orally, 1 time / D, group B given atorvastatin 20 mg atorvastatin, oral, once daily, group C placebo-controlled; give clopidogrel 75 mg / time, oral, once daily, other therapies were the same; using thromboelastography （Thrombelastography TEG） were detected in 5 of the d after platelet inhibition rate, detection indicators include： detection of reaction time, setting time, the setting angle, maximum coagulation vibration amplitude and other parameters. Results A group of platelet inhibition rate （53.4±7.2）%, group B platelet inhibition rate （46.5±6.8）%, C group, the platelet inhibition rate （56.7±5.9）%, compared group A and group B and C group, P〈0.05, with statistical difference, compared group A and group B, P〈0.05, with statistical difference. Conclusion Statins and clopidogrel can reduce clopidogrel platelet inhibition rate and different statin exist at the same time difference, rosuvastatin of atorvastatin compared with atorvastatin on clopidogrel platelet inhibition effect is small.

关 键 词：急性短暂性性脑缺血发作 他汀 氯吡格雷 血小板抑制率 

分 类 号：R743.31[医药卫生—神经病学与精神病学]