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目的研究在冠脉支架术后随访患者中不同剂量的阿托伐他汀与氯吡格雷长期联用产生的药物相互影响。方法105例冠心病患者,入院第2天随机服用阿托伐他汀和普伐他汀,66例行PC I术者入院当日加服氯吡格雷。共分为5组,A组23例,阿托伐他汀20 mg/d+氯吡格雷,B组20例,阿托伐他汀40 mg/d+氯吡格雷,C组23例,普伐他汀20 mg/d+氯吡格雷,D组20例,单用阿托伐他汀20 mg/d,E组19例,单用阿托伐他汀40 mg/d。分别在入院第1天及出院随访1、3月测定A、B、C组患者的血小板功能指标,并进行比较,测定各组的血脂等指标,分别比较A和D组、B和E组血脂等指标的差异。结果各组患者临床特征基线资料比较,差异无统计学意义;A、B、C组患者首次及随访1、3月测定的血小板功能指标CD62P、CD63、MPAR,组间差异无统计学意义,3组中各指标1、3月比基线均略有所下降(P<0.05),但1月和3月比较差异无统计学意义,CD62P、CD63、MPAR互为正相关(P<0.05);A和D组、B和E组在首次及治疗1、3月后相比较,血脂等在两对应组间差异均无统计学意义。结论冠脉支架术后40 mg/d以下的阿托伐他汀与常规剂量氯吡格雷较长时间联用,两药之间相互无明显影响,合用是安全的。
Objective To study the interaction between different doses of atorvastatin and clopidogrel in patients followed up after coronary stenting. Methods A total of 105 patients with coronary heart disease were randomized to receive atorvastatin and pravastatin on the second day after admission. Sixty-six patients undergoing PCI were given clopidogrel on the day of admission. A group of 23 cases, atorvastatin 20 mg / d + clopidogrel, B group 20 cases, atorvastatin 40 mg / d + clopidogrel, C group 23 cases, pravastatin 20 mg / d + clopidogrel, group D 20 cases, with atorvastatin 20 mg / d alone, group E 19 cases, with atorvastatin 40 mg / d alone. The platelet function indexes of patients in groups A, B and C were measured on the first day of hospital admission and on the first and third month of hospital discharge respectively. The blood lipid and other indexes of each group were compared. The levels of serum lipids And other indicators of the difference. Results There was no significant difference in the baseline data of clinical features between the groups. The platelet function indexes CD62P, CD63 and MPAR measured in the first, third, and third months of follow-up in groups A, B and C were not statistically different The index of each group in January and March decreased slightly from baseline (P <0.05), but there was no significant difference between January and March (P <0.05). The positive correlation between CD62P, CD63 and MPAR (P <0.05) Compared with the first and third and third months after treatment in groups D, B and E, there was no significant difference in blood lipids between the two groups. Conclusions Atorvastatin below 40 mg / d after coronary stent implantation is longer than that of conventional clopidogrel. The two drugs have no obvious effect on each other, and the combination is safe.