王新刚,季文君,龚艳君,郑博,屈晨雪,赵静,蒋捷,霍勇

• 1:北京大学第一医院心内科
• 2:北京大学第一医院心血管病研究所
• 3:北京大学第一医院临床检验科

摘要(Abstract)：

目的 评估稳定性冠心病患者分别接受替格瑞洛单药治疗和替格瑞洛联合阿司匹林双药治疗14 d后血小板聚集率的差异。方法 从2014—2015年北京大学第一医院随访门诊登记中纳入已经接受阿司匹林100 mg、每日1次和氯吡格雷75 mg、每日1次双联抗血小板治疗的稳定性冠心病患者，经替格瑞洛单药洗脱后，随机分配到替格瑞洛单药组或替格瑞洛联合阿司匹林双药组，并在基线洗脱前、随机化分组、7 d和14 d后进行血小板聚集率检测。结果 57例患者完成了完整的随访，平均年龄为（61.16±7.87）岁，其中替格瑞洛单药治疗组32例，替格瑞洛联合阿司匹林双药治疗组25例。两组花生四烯酸（AA）、二磷酸腺苷（ADP）和胶原诱导的血小板聚集率在基线和随机化分组时相似。治疗14 d后，ADP诱导的血小板聚集率两组均较基线明显降低，但两组间差异无统计学意义[（21.50±7.86）%比（21.92±10.21）%,P=0.864]。AA诱导的血小板聚集率两组较随机化分组时均有降低，但替格瑞洛单药治疗组明显高于替格瑞洛联合阿司匹林双药治疗组[（48.22±24.01）%比（8.67±5.96）%,P<0.001]。在替格瑞洛单药治疗组中，有5例患者AA诱导的血小板聚集率在停用阿司匹林后明显升高，继续替格瑞洛单药治疗14 d后AA诱导血小板聚集再次明显降低（<30%）。结论 替格瑞洛单药治疗除了对ADP诱导血小板聚集率有强效抑制作用外，对AA诱导的血小板聚集有轻度抑制作用，可能对双联抗血小板治疗患者早期降级为单药治疗有一定的临床意义。

关键词(KeyWords)： 替格瑞洛;冠心病;血小板聚集

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 王新刚,季文君,龚艳君,郑博,屈晨雪,赵静,蒋捷,霍勇

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