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非CYP3A4代谢和CYP3A4代谢的他汀类药物对脑梗死患者氯吡格雷抵抗的动态影响

The Dynamic Effect of Non-CYP3A4-Metabolized and CYP3A4-Metabolized Statins on Clopidogrel Resistance in Patients With Cerebral Infarction.

作者信息

Shi Hong Ting, Chen Yong Yuan, Li Xiao Ying, Luo Jian Hua, Zhong Guang Hong, Hu Jia Jia, Zhang Min, Zhou Bo Rong

机构信息

Department of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.

Department of Neurology, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.

出版信息

Front Pharmacol. 2021 Oct 6;12:738562. doi: 10.3389/fphar.2021.738562. eCollection 2021.

DOI:10.3389/fphar.2021.738562
PMID:34690774
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8526974/
Abstract

To explore the treatment effect of statins used together with clopidogrel on cerebral infarction (CI). One hundred and thirty non-clopidogrel resistant patients were divided into a dynamic clopidogrel resistant (DCR) group and a continuous Non clopidogrel resistance (NCR) group. Patients were randomly assigned to AC group (atorvastatin 40 mg/d + clopidogrel, 51 patients) and RC group (rosuvastatin 20 mg/d + clopidogrel, 47 patients). The patient's platelet aggregation rate (PAR) was measured on visit 0 (baseline), visit 1 (1 week after clopidogrel alone treatment), and visits 2 to 4 (one, three, and 6 months after clopidogrel plus statins treatment). The platelet reactivity index (PRI) was assessed on visits 0, 2, and 4, and clopidogrel thiol metabolite (H4) levels was measured on visits 2 and 4. DNA sequencing was used to determine , , and genotypes in all patients. PAR, PRI, and H4 levels, DCR ratio, and the genotype frequencies of , , and of both groups were similar ( > 0.05). *2 and *3 were independent risk factors for DCR ( < 0.05). Clopidogrel combined with atorvastatin does not affect platelet inhibition and does not increase the incidence of DCR. The incidence of DCR in the Chinese population is high and is related to

摘要

探讨他汀类药物与氯吡格雷联合应用对脑梗死(CI)的治疗效果。130例非氯吡格雷抵抗患者被分为动态氯吡格雷抵抗(DCR)组和持续非氯吡格雷抵抗(NCR)组。患者被随机分配至AC组(阿托伐他汀40mg/d + 氯吡格雷,51例患者)和RC组(瑞舒伐他汀20mg/d + 氯吡格雷,47例患者)。在就诊0(基线)、就诊1(单独使用氯吡格雷治疗1周后)以及就诊2至4(氯吡格雷加他汀类药物治疗后1、3和6个月)时测量患者的血小板聚集率(PAR)。在就诊0、2和4时评估血小板反应性指数(PRI),并在就诊2和4时测量氯吡格雷硫醇代谢物(H4)水平。采用DNA测序法测定所有患者的、和基因型。两组的PAR、PRI和H4水平、DCR比率以及、和的基因型频率相似(>0.05)。2和3是DCR的独立危险因素(<0.05)。氯吡格雷联合阿托伐他汀不影响血小板抑制,也不增加DCR的发生率。中国人群中DCR的发生率较高,且与……有关

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18ca/8526974/e4158ccf11ab/fphar-12-738562-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18ca/8526974/860a442fc187/fphar-12-738562-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18ca/8526974/f6d1e515d0bc/fphar-12-738562-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18ca/8526974/77abeb83003d/fphar-12-738562-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18ca/8526974/2d876648c7bc/fphar-12-738562-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18ca/8526974/fcfe9f1e9e3c/fphar-12-738562-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18ca/8526974/e4158ccf11ab/fphar-12-738562-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18ca/8526974/860a442fc187/fphar-12-738562-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18ca/8526974/f6d1e515d0bc/fphar-12-738562-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18ca/8526974/77abeb83003d/fphar-12-738562-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18ca/8526974/2d876648c7bc/fphar-12-738562-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18ca/8526974/fcfe9f1e9e3c/fphar-12-738562-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18ca/8526974/e4158ccf11ab/fphar-12-738562-g006.jpg

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