摘要
目的评价埃索美拉唑对非ST段抬高急性冠脉综合征(NSTE-ACS)患者支架置入术后应用氯吡格雷效果的影响。方法将102例患者随机均分为对照组和埃索美拉唑组,出院时均给予阿司匹林75 mg和氯吡格雷150 mg长期口服,埃索美拉唑组另给予埃索美拉唑20 mg口服,每日2次。以磷酸化血小板血管扩张剂刺激磷蛋白(VASP)磷酸化程度计算的血小板反应指数(PRI)用于评估氯吡格雷效果和对二磷酸腺苷(ADP)诱导的血小板聚集反应性(ADP-Ag)。结果随访1个月,埃索美拉唑组患者血小板氯吡格雷反应性与对照组有同样的效果,PRI VASP为(37.3±5.8)%对(39.4±6.3)%,P>0.05;血小板聚集反应性埃索美拉唑组与对照组有同样的效果,ADP-Ag为(51.3±14.6)%对(52.7±15.3)%,P>0.05。结论对于接受氯吡格雷治疗且同时需要质子泵抑制剂治疗时,建议应尽可能选择对CYP2C19抑制效力小的埃索美拉唑。
Objective To investigate the influence of esomeprazole on application effect of clopidogrel after stent implantation in non-ST-segment elevation acute coronary syndromes（NSTE-ACS）.Methods A total of 102 patients undergoing coronary stenting for NSTE-ACS were prospectively divided into to the control group and the esomeprazole group randomly and evenly.At discharge from hospital,all the cases received 75 mg aspirin and 150 mg clopidogrel for long-term oral administration.In addition,the esomeprazole group was given oral esomeprazole 20 mg,twice daily.The platelet reactivity index（PRI） calculated by phosphorylation of vasoactive stimulated phosphoprotein（VASP） was used to assess the clopidogrel effect and adenosine diphosphate（ADP）-induced aggregation for platelet reactivity（ADP-Ag）.Results After 1-month follow up,the control group and the esomeprazole group had nearly the same platelet response to clopidogrel as assessed with PRI VASP[（37.3±5.8）%versus（39.4±6.3）%,P 0.05].The platelet reactivity with ADP-Ag had the same effect between the esomeprazole group and the control group[（51.3±14.6）%versus（52.7±15.3%）,P 0.05].Conclusion It is recommended that esomeprazole with little inhibition effect to CYP2C19 should be chosen to treat the patients receiving clopidogrel therapy and simultaneously needing proton pump inhibitors（PPI） treatment.
出处
《中国药业》
CAS
2011年第12期21-23,共3页
China Pharmaceuticals
