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阿司匹林与氯吡格雷双联抗血小板被广泛用于急性冠状动脉综合征及经皮冠状动脉介入治疗术后的患者。质子泵抑制剂(PPI)被推荐降低抗血小板药物引起的胃肠道损害,但研究发现PPI影响氯吡格雷的临床药效。提示临床医师应合理选择使用与氯吡格雷相互作用的PPI,或应用不影响CYP2C19途径的H2受体拮抗剂,或在服用氯吡格雷4 h后再服用PPI,积极防控血栓事件的同时降低消化道出血风险。
Aspirin and clopidogrel dual antiplatelet are widely used in patients with acute coronary syndrome and percutaneous coronary intervention. Proton pump inhibitors (PPIs) are recommended to reduce gastrointestinal damage caused by antiplatelet drugs, but studies have found that PPI affects the clinical efficacy of clopidogrel. It is suggested that clinicians should choose PPI which interacts with clopidogrel rationally, or use H2 receptor antagonist which does not affect CYP2C19 pathway, or take PPI 4 hours after taking clopidogrel, and actively prevent and control thrombosis while reducing Risk of gastrointestinal bleeding.