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目的探讨替格瑞洛对氯吡格雷低反应患者血小板聚集率(PAR)的影响。方法接受经皮冠状动脉介入术(PCI)冠心病患者予口服阿司匹林100mg/d+氯吡格雷75mg/d后,均经光学比浊法证实存在氯吡格雷低反应[以二磷酸腺苷诱导的PAR(PLADP)>40%)]的52例均分为A组(口服氯吡格雷75mg/d)和B组(口服替格瑞洛90mg,每日2次)。两组均继续服用阿司匹林100mg/d;1个月后复查PAR。结果 A、B组治疗前和治疗1个月后花生四烯酸诱导的PAR比较均无统计学差异(P>0.05)。治疗前,A、B组PL_(ADP)相仿[(52.46±7.12)%vs.(53.42±7.27)%](P>0.05);治疗后,B组PL_(ADP)低于A组[(20.08±12.38)%vs.(49.96±9.52)%]和治疗前(P<0.01)。结论对于PCI术后氯吡格雷低反应患者,更换替格瑞洛治疗能显著降低PAR。
Objective To investigate the effect of ticagrelor on platelet aggregation rate (PAR) in patients with low response to clopidogrel. Methods Percutaneous coronary intervention (PCI) patients with coronary heart disease were given oral aspirin 100mg / clopidogrel 75mg / d, were confirmed by optical turbid clopidogrel low response [with adenosine diphosphate induced PAR (PLADP)> 40%)] were divided into group A (oral clopidogrel 75mg / d) and group B (ticagrelos 90mg twice daily). Both groups continue to take aspirin 100mg / d; 1 month after the review of PAR. Results There was no significant difference in arachidonic acid induced PAR between group A and B before treatment and one month after treatment (P> 0.05). Before treatment, PL ADP in group A and B were similar [(52.46 ± 7.12)% vs (53.42 ± 7.27)%] (P 0.05) ± 12.38)% vs (49.96 ± 9.52)%] and before treatment (P <0.01). Conclusions For patients with low response to clopidogrel after PCI, switching to ticagrelor significantly reduced PAR.