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目的:观察埃索美拉唑、雷贝拉唑、雷尼替丁或法莫替丁对急性冠脉综合症(ACS)患者冠脉支架术后应用氯吡格雷抗血小板功能的影响。方法:150例行经皮冠状动脉介入治疗(PCI)的ACS患者,入院后给予阿司匹林300 mg/d,氯吡格雷300 mg负荷剂量继以75 mg/d维持剂量抗血小板治疗,并随机分为质子泵抑制剂(PPI)A组(A1组:埃索美拉唑40 mg/d,n=30,A2组:雷贝拉唑20 mg/d,n=30)、H2受体拮抗剂(H2RA)B组(B1组:雷尼替丁300 mg/d,n=30,B2组:法莫替丁40 mg/d,n=30)和空白对照C组(C组:n=30)。采用ELISA法检测血浆CD62P、GPⅡb/Ⅲa含量及电阻抗法检测血小板聚集功能。结果:PPI或H2RA治疗前后,A组、B组与C组相比,上述指标的差值组间比较均无明显统计学差异,A1组、A2组、B1组、B2组与C组相比,治疗前后上述指标的差值组间比较均无统计学差异。结论:埃索美拉唑、雷贝拉唑、雷尼替丁或法莫替丁对氯吡格雷的抗血小板活性无明显的影响。
Objective: To observe the effects of esomeprazole, rabeprazole, ranitidine and famotidine on the antiplatelet function of clopidogrel following coronary stent in patients with acute coronary syndrome (ACS). Methods: 150 ACS patients undergoing percutaneous coronary intervention (PCI) were given aspirin 300 mg / d after admission, clopidogrel 300 mg loading dose followed by 75 mg / d maintenance dose antiplatelet therapy and were randomly divided into Proton pump inhibitor (PPI) group A (group A1: esomeprazole 40 mg / d, n = 30, group A2: rabeprazole 20 mg / d, n = 30), H2 receptor antagonist H2RA) group B (n = 30 in group B1: ranitidine 300 mg / d, n = 30 in group B2: famotidine 40 mg / d, n = . The contents of CD62P, GPⅡb / Ⅲa in plasma were detected by ELISA and the platelet aggregation was detected by electrical impedance spectroscopy. Results: Before and after treatment with PPI or H2RA, there was no significant difference between the groups of A, B and C, there was no significant difference between the groups in the indexes of A1, A2, B1, B2 , Before and after treatment the difference between the above indicators were no significant difference between groups. CONCLUSION: Esomeprazole, rabeprazole, ranitidine or famotidine had no significant effect on the antiplatelet activity of clopidogrel.