氯吡格雷更换为替格瑞洛抗血小板聚集疗效的前后对比

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Abstract Objective To explore the comparison of anti-platelet aggregation effect of Clopidogrel replaced to Ticagrelor in patients with acute coronary syndrome.Methods Thirty-one patients with acute coronary syndrome treated in Peking University International Hospital from April to November 2018 were selected as the research objects,all patients received thromboelastomeric adenosine diphosphate (ADP) inhibition rate test (stage A data) after clopidogrel treatment,then discontinuing Clopidogrel and replaced it with Ticagrelor to test the ADP inhibition rate (stage B data)of the thromboelastometry chart again,the results of the ADP inhibition rate tests was compared.After the Clopidogrel was replaced with Ticagrelor,the ADP inhibition rate test was performed on the thromboelastometry chart,the test was divided into three groups according to the time interval between the blood collection time point and the last dose of Clopidogrel,the first group (24-＜36 h),the second group (36-＜96 h),and the third group (≥96 h).The general data of the three groups and the ADP inhibition rate of the thromboelastic diagrams at the A and B stages were compared,and CYP2C19 genotype was detected in 24 patients.Results The thromboelastomeric ADP inhibition rate of three groups in B stage was higher than that in A stage,the difference was statistically significant (P＜0.05).17 of the 24 patients with CYP2C19 genotypes (CYP2C19*1/*1) were normal,among the 17 cases,10 cases (58.8%) took clopidogrel and the inhibition rate of ADP was less than 30%,however,the inhibition rate of ADP increased to more than 50% in 9 of the 10 patients after replacement with Ticagrelor.Conclusion The replacement of Clopidogrel with Ticagrelor has better anti-platelet aggregation effect,and the treatment of Ticagrelor in patients with acute coronary syndrome has better anti-platelet aggregation effect.Even in patients with normal metabolism,there may be resistance to Clopidogrel,and the anti-platelet aggregation effect is improved after replacement with Ticagrelor.

Key words： Clopidogrel Ticagrelor Thromboelastography Platelet Adenosine diphosphate inhibition rate

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	WANG Guang-liang
	WU Xue-mei

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WANG Guang-liang,WU Xue-mei. Before and after comparison of the anti-platelet aggregation effect of Clopidogrel replaced to Ticagrelor[J]. 中国当代医药, 2020, 27(1): 157-161.

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http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2020/V27/I1/157

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