ACM  >> Vol. 5 No. 3 (September 2015)

    阿托伐他汀联合替格瑞洛治疗急性冠脉综合症介入术后患者两种药物临床疗效的相互影响
    The Mutual Effect of Clinical Efficacy of Atorvastatin Combined with Ticagrelor for Patients with Acute Coronary Syndrome after Interventional Treatment

  • 全文下载: PDF(327KB) HTML   XML   PP.188-192   DOI: 10.12677/ACM.2015.53030  
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作者:  

宋 剑:包头医学院研究生学院,内蒙古 包头;
刘美莲,朱王亮,陈丽珠,李 莉,郑玉云:包头医学院第一附属医院,内蒙古 包头

关键词:
替格瑞洛阿托伐他汀急性冠脉综合症药物相互作用Ticagrelor Atorvastatin Acute Coronary Syndrome Drug Interaction

摘要:

目的:探究急性冠脉综合症患者介入术后使用阿托伐他汀与替格瑞洛联用两种药物临床效果及其副作用的相互影响。方法:收集我院2014年心内科入院患者120例,经临床症状和冠脉造影诊断为急性冠脉综合症,将入选患者随机分为阿托伐他汀氯吡格雷组、阿托伐他汀替格瑞洛组,测定各组患者血清尿酸、转氨酶、肌酸激酶、血小板聚集率、血脂水平等,比较在临床疗效上是否存在相互影响。结果:与氯吡格雷组相比,替格瑞洛组在抗血小板聚集率有统计学意义(P < 0.05),两组血脂血平无统计学意义(P < 0.05)。结论:尽管研究显示阿托伐他汀、替格瑞洛存在CYP3A4的竞争性抑制,药动学方面有一定影响,但短期各自的临床疗效改变不显著。

Objective: To explore the clinical effects and side effect of atorvastatin combined with ticagrelor for patients with acute coronary syndrome after interventional treatment. Methods: 120 cases of hospitalized patients in our Department of Cardiology of 2014 was collected, according to the clinical symptoms and coronary angiography in the diagnosis of acute coronary syndrome (ACS), the selected patients were randomly divided into the atorvastatin clopidogrel group and atorvastatin for Greg groups, we measured serum uric acid, transaminase, creatine kinase, platelet aggregation rate, lipid levels, etc. of the patients and compared whether there was influence of the clinical curative effect on each other. Results: There were significant differences between clopidogrel group and Greg los group in blood platelet aggregation rate (P < 0.05), and no significant differences in blood lipid levels (P > 0.05). Conclusions: Studies have shown competitive inhibition of CYP3A4 between atorvastatin and ticagrelor, resulting in certain influence on the pharmacokinetics, however, their clinical efficacy showed no significant change in the short term when used in combination.

文章引用:
宋剑, 刘美莲, 朱王亮, 陈丽珠, 李莉, 郑玉云. 阿托伐他汀联合替格瑞洛治疗急性冠脉综合症介入术后患者两种药物临床疗效的相互影响[J]. 临床医学进展, 2015, 5(3): 188-192. http://dx.doi.org/10.12677/ACM.2015.53030

参考文献

[1] Shand, J.A., Menown, I.B. and Storey, R.F. (2011) Ticagrelor: From concept to clinical evaluation. Biomarkers in Medicine, 5, 53-62.
http://dx.doi.org/10.2217/bmm.11.4
[2] Abtahian, F., Yonetsu, T., Vergallo, R., Jia, H.B., Kato, K., Tian, J.W., et al. (2013) Ticagrelor immediately prior to stentmg is associated with smaller residual thrombus in patients with acute coronary syndrome. International Journal of Cardiology, 168, 3099-3101.
http://dx.doi.org/10.1016/j.ijcard.2013.04.076
[3] Steg, P.G., Harrington, R.A., Emanuelsson, H., Katus, H.A., Mahaffey, K.W., Meier, B., et al. (2013) Stent thrombosis with ticagrelor versus clopidogrel in patients with acute co-ronary syndromes: An analysis from the prospective, randomized PLATO trial. Circulation, 128, 1055-1065.
[4] Kohli, P., Wallentin, L., Reyes, E., Horrow, J., Husted, S., Angiolillo, D.J., et al. (2013) Reduction in first and recurrent cardiovascular events with ticagrelor compared with clopidogrel in the PLATO study. Circulation, 127, 673-680.
[5] Ferri, N., Corsini, A. and Bellosta, S. (2013) Pharmacology of the new P2Y12 receptor inhibitors: insights on pharmacokinetic and pharmacodynamic properties. Drugs, 73, 1681-1709.
http://dx.doi.org/10.1007/s40265-013-0126-z
[6] 龚世菊, 张志刚, 谭文明 (2015) 辛伐他汀与替格瑞洛联用后对相互临床疗效的影响. 中国医院用药评价与分析, 6, 737-739.
[7] Wallentin, L., Becker, R.C., Budaj, A., Cannon, C.P., Emanuelsson, H., Held, C., et al. (2009) Ticagredor versus clopidogrel in patients with acute coronary syndromes. The New England Journal of Medicine, 361, 1045-1057
[8] Steiner, S., Moertl, D., Chen, L., Coyle, D. and Wells, G.A. (2012) Network meta-analysis ticagrelor, high- and standard-dose clopidogrel in patients of prasugrel, scheduled for percutaneoucoronary interventions. Thrombosis and Haemostasis, 108, 318-327.
http://dx.doi.org/10.1160/TH11-08-0586
[9] Tend, R., Mitchell, P.D. and Butler, K.A. (2013) Phaimacokinetic interaction studies of co-administration of ticagrclor and atorvastatin or simvastatin in healthy volunteers. European Journal of Clinical Pharmacology, 69, 177-187.
[10] Catttaneo, M. and Faioni, E.M. (2012) Why does ticagrelor induce dyspnea. Thrombosis and Haemostasis, 108, 1031- 1036.
http://dx.doi.org/10.1160/TH12-08-0547