氯吡格雷抵抗原因及对策的研究进展

中国临床药理学与治疗学 ›› 2009, Vol. 14 ›› Issue (10): 1168-1173.

氯吡格雷抵抗原因及对策的研究进展

余长永^1,3, 张勇^1,3, 邹建军¹, 燕翔², 马海涛³, 倪斌³, 朱余兵¹, 樊宏伟¹, 贺春晖²

¹南京医科大学附属南京第一医院临床药理实验室, 南京 210006, 江苏;
²南京医科大学药学院, 南京 210029, 江苏;
³苏州大学附属第一医院心胸外科, 苏州 215006, 江苏

收稿日期:2009-09-02 修回日期:2009-09-30 发布日期:2020-10-29
通讯作者: 邹建军,男,博士,主管药师,主要从事药物代谢动力学和临床药学研究。Tel:13814186761 E-mail:zoujianjun100@126.com
作者简介:余长永,男,硕士研究生,主要从事心血管临床药理学和临床治疗学研究。Tel:15150556279 E-mail:ycywyw125@126.com
基金资助:
国家自然科学基金资助项目(30901830)

Advances on the causes and strategies of clopidogrel resistance

YU Chang-yong^1,3, ZHANG Yong^1,3, ZOU Jian-jun¹, YAN Xiang², MA Hai-tao³, NI Bin³, ZHU Yu-bing¹, FAN Hong-we, HE Chun-hui²

¹Department of Clinical Pharmacology, Nanjing First Hospital of Nanjing Medical University, Nanjing 210006, Jiangsu, China;
2College of Pharmacy, Nanjing Medical University, Nanjing 210029, Jiangsu;
3Department of Cardiovascular and Thoracic Surgery, the First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu, China

Received:2009-09-02 Revised:2009-09-30 Published:2020-10-29

摘要/Abstract

摘要： 众所周知, 血小板在动脉血栓形成中起到了关键的作用, 抗血小板治疗已成为急性冠脉综合征患者预防和治疗动脉血栓的基石。氯吡格雷作为一种新型抗血小板药物, 对心血管病的重要辅助治疗作用已得到证实。但研究发现, 大约有11 %~ 44 %患者对氯吡咯雷表现为低反应甚至无反应, 定义为氯吡格雷抵抗。而导致此种抵抗现象的可能原因是氯吡格雷给药剂量不足, 个体的基因多态性和药物之间的相互作用等。其主要对策有提高氯吡格雷的给药剂量, 联用其它抗血小板药物, 减少药物的不良相互作用和采用新型药物等。

关键词: 氯吡格雷抵抗, 血小板聚集, 二磷酸腺苷

Abstract: As we all know, platelets play a key role in the formation of arterial thrombosis and antiplatelet therapy has become the cornerstone for the prevention and treatment of arterial thrombosis in patients with acute coronary syndrome.Clopidogrel is a new antiplatelet drug, which has been confirmed as an important adjuvant therapy of cardiovascular disease.However, Many studies have found that about 11 %-44 %of patients show low response even non-response to clopidogrel, which is defined as clopidogrel resistance.The causes, which lead to this resistance phenomenon, may be due to inadequate doses of clopidogrel administration, the individual gene polymorphism, drug interactions and so on.The main strategies of clopidogrel resistance include increasing doses of clopidogrel administration, combining with other antiplatelet drugs, reducing adverse drug interactions and using of new drugs.

Key words: clopidogrel resistance, platelet aggregation

中图分类号:

余长永, 张勇, 邹建军, 燕翔, 马海涛, 倪斌, 朱余兵, 樊宏伟, 贺春晖. 氯吡格雷抵抗原因及对策的研究进展[J]. 中国临床药理学与治疗学, 2009, 14(10): 1168-1173.

YU Chang-yong, ZHANG Yong, ZOU Jian-jun, YAN Xiang, MA Hai-tao, NI Bin, ZHU Yu-bing, FAN Hong-we, HE Chun-hui. Advances on the causes and strategies of clopidogrel resistance[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2009, 14(10): 1168-1173.

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