摘要
目的:评价联合抗血小板治疗方案的有效性及安全性,以探讨西洛他唑+氯吡格雷联合治疗非ST段抬高急性冠脉综合征(NSTE-ACS)患者的应用价值。方法:将63例确诊为NSTE-ACS的患者,随机分为两组,A组(31例):口服西洛他唑100mgbid+氯吡格雷75mgqd;B组(32例):口服阿司匹林100mgqd+氯吡格雷75mgqd。利用流式细胞术分别检测治疗前、治疗第7、14天的血小板膜糖蛋白[纤维蛋白原受体(PAC-1)和P选择素(CD62P)]的表达率,计算并比较其抑制率,观察治疗过程中主要不良心脏事件(MACE)发生率、出血并发症。结果:两组PAC-1或CD62P的表达率在治疗第7、14天均较治疗前明显下降(P<0.01),第14天最显著。治疗前,治疗第7、14天A组和B组同期的PAC-1、CD62P表达率之间差异无统计学意义(P>0.05);两组在相同治疗时间点对PAC-1、CD62P抑制率差异无统计学意义(P<0.05);两组MACE发生率对比无统计学差异(P<0.05),A组的出血并发症明显少于B组(P<0.05)。结论:对NSTE-ACS患者,西洛他唑+氯吡格雷对血小板抑制的近期效果与阿司匹林+氯吡格雷方案相似,且安全性更好。
AIM： To evaluate the efficacy and safety of the antiplatelet agent cilostazol combinated with clopidogrel in patients with acute coronary artery syndrome without ST-segment elevation （NSTE-ACS）. METHODS： 63 patients with NSTE-ACS were randomly divided into tow groups. Group A（ n = 31） received cilostazol （ 100 mg bid） plus clopidogrel （75 mg once daily）, Group B（ n = 32） received aspirin （ 100 mg once daily） plus clopidogrel （75 mg once daily）,the treatment course was 14 days. The expression and inhibition rates of platelet membrane glycopmtein （PAC-1 and CD62P ）were measured by flow cytometry before anti-platelet therapy, 7 days and 14 days after initial therapy. The major adverse cardiac event and bleeding complication were monitored. RESULTS： There are lower expression rate at 7 days and 14 days after initial therapy than before therapy in both two groups（P 〈 0.01）, the lowest at 14 days after initial therapy. The expression levels of PAC-1 or CD62 had no significant difference between two groups in the same time point（ P 〈 0.05）; Inhibition rates of PAC-1 or CD62 had also no significant difference beween two groups in the same time point（ P 〉 0.05）. Moreover, there was no statistically significant difference in occurrence rate of major adverse cardiac event （MACE） between these two groups（P 〈 0.05） while Group A had less hemorrhage complications than Group B （P 〈0.05）. CONCLUSION： For patients with NSTEACS, anti-platelet efficiency of cilostazol plus clopidogrel are similar to aspirin plus clopidogrel whereas the previous is safer .
出处
《中国临床药理学与治疗学》
CAS
CSCD
2008年第5期557-562,共6页
Chinese Journal of Clinical Pharmacology and Therapeutics
