Tranchesi B, Pileggi F, Vercammen E, Van de Werf F, Verstraete M
Instituto do Coraçao (INCOR), University of Sao Paulo, Brasil.
Eur Heart J. 1994 May;15(5):660-4. doi: 10.1093/oxfordjournals.eurheartj.a060564.
Ridogrel, a compound with the dual property of inhibiting the synthesis of thromboxane and blocking the receptors of thromboxane/prostaglandin/endoperoxides, has been shown to accelerate the speed of recanalization and to delay or prevent reocclusion during systemic thrombolysis with tissue plasminogen activator in experimental animals. Ninety patients who had not taken any antiplatelet drugs within the last 10 days were randomized to either intravenous ASA 250 mg immediately before the thrombolytic treatment and 100 mg once a day orally thereafter or ridogrel 300 mg i.v. before thrombolytic treatment and 300 mg b.i.d. orally thereafter. All patients were given intravenous heparin concomitantly with alteplase. The patency of the infarct-related artery was determined by coronary angiography before the administration of the thrombolytic agent and by repeated coronary angiography every 15 min until the end of the administration of alteplase. A final angiogram was obtained 48 to 72 h later. At 90 min, the recanalization and patency rates were the same in the two treatment groups with no intergroup difference in the speed of recanalization.
利多格雷是一种具有抑制血栓素合成及阻断血栓素/前列腺素/内过氧化物受体双重特性的化合物,在实验动物中,已证明其在使用组织纤溶酶原激活剂进行全身溶栓期间,可加快再通速度,并延迟或防止再闭塞。90例在过去10天内未服用任何抗血小板药物的患者被随机分为两组,一组在溶栓治疗前立即静脉注射250mg阿司匹林,之后每天口服100mg;另一组在溶栓治疗前静脉注射300mg利多格雷,之后每天口服两次,每次300mg。所有患者在使用阿替普酶的同时均静脉给予肝素。在给予溶栓剂之前通过冠状动脉造影确定梗死相关动脉的通畅情况,并在阿替普酶给药结束前每隔15分钟重复进行冠状动脉造影。48至72小时后获得最终血管造影照片。在90分钟时,两个治疗组的再通率和通畅率相同,再通速度无组间差异。