分析急性冠状动脉综合征患者体内氯吡格雷活性代谢产物的影响因素

发布时间：2018-05-08 18:08

本文选题：急性冠状动脉综合征 + 氯吡格雷　；参考：《中国临床药理学杂志》2017年04期

【摘要】：目的分析影响急性冠状动脉综合征(ACS)患者体内氯吡格雷活性代谢产物血浆浓度的主要因素。方法105例ACS患者均给予阿司匹林100 mg·d~(-1)及氯吡格雷75 mg·d~(-1),连续口服4 d;第5天晨起空腹给药1 h后,抽取静脉血4 m L,用乙二胺四乙酸抗凝。其中2 m L立即加入500 mmol·L~(-1)的2-溴-3’-甲氧基苯乙酮(MPB)溶液20μL,用于检测氯吡格雷活性代谢产物的浓度;另2 m L用于荧光检测细胞色素P450 2C19*2(CYP2C19*2)、*3和氧磷酶1(PON1)基因型。用单因素分析探索二分类变量及等级资料对氯吡格雷活性代谢产物血药浓度的影响,用Spearman分析探索氯吡格雷活性代谢产物血药浓度与连续性变量的相关性。结果糖尿病、高脂血症、PON1携带、进行经皮冠状动脉介入手术后与氯吡格雷活性代谢产物血药浓度呈负相关(P0.05),β受体阻滞药、他汀类药物、血清白蛋白(ALB)与氯吡格雷活性代谢产物的浓度呈正相关(P0.05)。结论糖尿病、高脂血症、PON1携带及进行经皮冠状动脉介入手术后等可减少氯吡格雷活性代谢产物血药浓度,而ALB以及合用β受体阻滞药或他汀类药物可增加其血药浓度。
[Abstract]:Objective to analyze the main factors influencing the plasma concentration of clopidogrel metabolites in patients with acute coronary syndrome (ACS). Methods one hundred and five patients with ACS were given aspirin 100mg / d and clopidogrel 75mg / d for 4 days, and 4 mL venous blood was taken after 1 hour of fasting administration of clopidogrel in the morning of the fifth day, and then treated with ethylenediamine tetraacetic acid (ETAA) as anticoagulant. 2 mL was used to detect the concentration of active metabolites of clopidogrel in 20 渭 L of 2-bromo-3-methoxyacetophenone (MPB) solution. Single factor analysis was used to explore the effect of two classification variables and grade data on the concentration of clopidogrel active metabolites in blood, and Spearman analysis was used to explore the correlation between blood concentration of clopidogrel active metabolites and continuous variables. Results there was a negative correlation between serum concentration of clopidogrel active metabolites, 尾 receptor blockers, and statins in patients with diabetes mellitus and hyperlipidemia, after percutaneous coronary intervention, there was a negative correlation between the concentration of PON1 and clopidogrel active metabolites, 尾 -receptor blockers and statins. Serum albumin (ALB) was positively correlated with the concentration of clopidogrel active metabolites (P 0.05). Conclusion the serum concentration of clopidogrel metabolites can be reduced by carrying PON1 in diabetes mellitus, hyperlipidemia and after percutaneous coronary intervention, while ALB and 尾 -receptor blockers or statins can increase the serum concentration of clopidogrel.
【作者单位】：河北医科大学第二医院药学部;华北理工大学临床医学院;
【分类号】：R973

【相似文献】