摘要
目的:探讨在中国人群中奥美拉唑、泮托拉唑是否降低氯吡格雷的抗血小板效应。方法:接受择期冠状动脉介入治疗或药物治疗的急性冠状动脉综合征患者在常规氯吡格雷、阿司匹林治疗基础上,将患者随机分为奥美拉唑组(奥美拉唑40 mg/d,n=30)和泮托拉唑组(泮托拉唑40 mg/d,n=30),分别于治疗前及治疗后7天抽血测定血管扩张刺激磷蛋白(VASP)磷酸化水平计算血小板反应性指数(PRI)及二磷酸腺苷诱导的血小板聚集率(ADP-Ag),并观察30天的主要心血管事件。结果:两组一般资料比较差异无统计学意义(P>0.05);奥美拉唑组治疗后第7天与治疗前相比血小板聚集率及血小板反应性指数数值均显著下降,差异有统计学意义(P<0.05～0.01);泮托拉唑组治疗后第7天与治疗前相比血小板聚集率数值显著下降,差异有统计学意义(P<0.01),但血小板反应性指数与治疗前相比差异无统计学意义(P>0.05)。两组组间治疗后第7天和治疗前血小板聚集率及血小板反应性指数比较差异均无统计学意义(P>0.05);两组的30天主要不良心血管事件差异无统计学意义(P>0.05)。结论:奥美拉唑对双联抗血小板治疗效应无明显影响,但泮托拉唑可能具有抑制氯吡格雷的抗血小板治疗实验室效应。
Objective：To assess the effects of proton pump inhibitors omeprazole and pantoprazole on the antiplatelet therapy of clopidogrel in clinical practice.
Methods：The patients who underwent selective percutaneous coronary intervention or the patients with acute coronary artery syndrome received the conservative therapy were randomized for dual antiplatelet therapy of aspirin and clopidogrel associated with either omeprazole 40mg/day （ Omeprazole group） or pantoprazole 40mg/day （ Pantoprazole group ） respectively, n = 30 in each group. The expression of platelet reactivity index （ PRI）, and platelet aggregation rate induced by adenosine diphosphate （ ADP- Ag） were examined 7 days before and 7 days after the medication, the major cardiovascular events were observed and compared in 30 days between two groups.
Results：There were no real differences in the baseline information before and ＇after the associated medications in neither groups,P〉0. 05. In Omeprazole groups, the ADP-Ag and PRI were decreased after the medication, P〈0. 05 respectively. In Pantoprazole group, ADP-Ag was decreased after the medication,P〈0. 01 while PRI was similar than it was before, P〉0. 05. There were no significant differences for major cardiovascular events in 30 days between two groups ,P〉0. 05.
Conclusion：Omeprasole does not impact the efficacy of dual antiplatelet therapy of aspirin and clopidogrel, while pantoprazole might inhibit the antiplatelet efficacy of clopidogrel in clinical practice.
出处
《中国循环杂志》
CSCD
北大核心
2011年第3期182-185,共4页
Chinese Circulation Journal
基金
广东省药学会心血管合理用药基金项目:2009×16
