摘要
目的研究急性冠状动脉综合征(ACS)患者在抗血小板治疗(阿司匹林和氯吡格雷)后再联用阿托伐他汀对对氯吡格雷羧酸衍生物血浓度和血小板聚集率的影响。方法健康受试者(25例)口服拜阿司匹林肠溶片、氯吡格雷和阿托伐他汀(100,75,20 mg·d-1),第5 d停用阿托伐他汀,继续口服氯吡格雷和阿司匹林。ACS患者(66例)在常规治疗基础上,与健康受试者有相同的治疗方案。分别于第5,9 d用HPLC-MS/MS测量氯吡格雷羧酸衍生物血浓度,用流式细胞仪测定血小板聚集率。结果在抗血小板治疗加阿托伐他汀治疗与仅抗血小板治疗,氯吡格雷羧酸衍生物血浓度:在健康组分别为(5.76±0.87),(5.67±0.88)ng·dL-1;在ACS患者分别为(5.96±0.87),(5.86±0.97)ng·dL-1,两者间差异均无统计学意义(P=0.35,0.12)。提示联用他汀和氯吡格雷并不影响氯吡格雷羧酸衍生物血浓度,两药间无相互作用。在同样条件下,血小板聚集率:健康组分别为(44.25±16.37)%,(47.61±16.67)%;患者组分别为(47.70±15.07)%,(47.02±15.45)%,两者间差异均无统计学意义(P=0.08,0.62),表明2组联用氯吡格雷与阿托伐他汀均不影响氯吡格雷的抗血小板治疗效果。结论本研究未检测到血氯吡格雷原药成分;氯吡格雷和阿托伐他汀间无相互作用。
Objective To investigate the effects of atorvastatin and clopidogrel in patients with acute coronary syndrome （ACS） on carboxylic acid derivatives of blood concentration and rate of platelet aggregation. Methods The 25 healthy subjects and 66 cases of patients with ACS were involved. Basis on the common treatment in ACS patients, all subjects and patients were given aspirin 100 mg· d^-1 , clopidogrel 75 mg · d^-1, and atorvastatin 20 mg · d^-1,5 days later discontinued the atorvastatin only. The 5,9 days after treatment, the clopidogrel carboxylic acid derivatives blood concentration was measured by HPLC - MS/MS. The platelet aggregation rate was determinate by flow cytometry. Results In course of the double antiplatelet therapy plus atorvastatin therapy and double antiplatelet therapy only, the concentrations in plasma of clopidogrel carboxylic acid were （5.76 ±0. 87）, （5.67 ±0. 88） ng · dL^-1 in healthy group; while were （5.96 ±0. 87）, （5. 86 ±0. 97 ） ng · dL^- 1 in patients group, respectively. There wash＇ t significant difference （ P 〉 0. 05 ）. In the same conditions, platelet aggregation rate were （44.25 ±16. 37）%, （47.61 ±16. 67）% in healthy group while it were （47.70 ±15.07）%, （47.02 ±15. group, respectively. There was not significant difference （ P 〉 0. 05 ） also. Conclusion blood was not detect. There is no interaction between atorvastatin and clopidogrel. Clopidogrel 45） % in ACS predecessor in blood was not detect. There is no interaction between atorvastatin and clopidogrel.
出处
《中国临床药理学杂志》
CAS
CSCD
北大核心
2013年第11期807-809,共3页
The Chinese Journal of Clinical Pharmacology
基金
甘肃省卫生行业科研计划基金资助项目(GSWST2010-21)
