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目的:通过比较冠心病患者单用或联用阿斯匹林、氯吡格雷前后血小板聚集功能,以指导临床用药。方法:将97例冠心病患者分成阿斯匹林组、氯吡格雷组和阿斯匹林与氯吡格雷两者联合用药组,比较各组用药前后四种不同诱导剂作用下血小板最大聚集率。结果:阿斯匹林组由花生四烯酸诱导血小板最大聚集率(29.9±11.0)与正常对照组(78.0±13.1)及用药前(96.8±8.1)比差异有非常显著意义;与之类似,氯吡格雷组由二磷酸腺苷诱导的血小板最大聚集率差异有非常显著意义;而联合用药组四种诱聚剂诱导的血小板最大聚集率差异均有显著意义。结论:阿斯匹林和氯吡格雷单用时对血小板聚集抑制作用仅限于ACA、ADP,而联合用药对四种诱聚剂均有抑制作用,因此联合用药对预防血栓形成更为有效。
OBJECTIVE: To compare the effect of aspirin and clopidogrel before and after platelet aggregation in patients with coronary heart disease to guide clinical use. Methods: Ninety-seven patients with coronary heart disease were divided into aspirin group, clopidogrel group and aspirin and clopidogrel combination group. The maximal aggregation rate of platelet under four different inducing agents . Results: The maximum platelet aggregation rate induced by arachidonic acid in aspirin group (29.9 ± 11.0) was significantly higher than that in the normal control group (78.0 ± 13.1) and before treatment (96.8 ± 8.1). Similarly, The difference of platelet aggregation rate induced by adenosine diphosphate in clopidogrel group was significant, while the difference of platelet aggregation rate induced by four kinds of decokers in combination group was significant. CONCLUSIONS: Aspirin and clopidogrel alone inhibit the platelet aggregation only in ACA and ADP, and combination therapy can inhibit all four kinds of decokers. Therefore, combination therapy is more effective in preventing thrombosis.