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EuroPCR 2014：吗啡或延缓新型口服抗血小板药起效时间

2014-05-27 高晓方 译 医学论坛网

EuroPCR吗啡新型口服抗血小板药起效时间STEMI
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一项新研究表明，在因ST段抬高性心肌梗死(STEMI)而接受直接经皮冠状动脉介入治疗(PCI)的患者中，吗啡应用可能延缓新型口服抗血小板药的起效时间，进而可能增加患者风险。Guido Parodi博士在2014年欧洲血运重建大会(EuroPCR 2014)上报告了上述研究。他强调，虽然该研究只观察了血小板反应性而未观察硬临床事件，但医生也应注意新型P2Y12抑制剂和吗啡的潜在相互作用。 研究者既

一项新研究表明，在因ST段抬高性心肌梗死(STEMI)而接受直接经皮冠状动脉介入治疗(PCI)的患者中，吗啡应用可能延缓新型口服抗血小板药的起效时间，进而可能增加患者风险。Guido Parodi博士在2014年欧洲血运重建大会(EuroPCR 2014)上报告了上述研究。他强调，虽然该研究只观察了血小板反应性而未观察硬临床事件，但医生也应注意新型P2Y12抑制剂和吗啡的潜在相互作用。

研究者既往确认吗啡为治疗后高残留血小板活性(HPPR)的独立预测因素，并以此为基础将分析扩展至其他4项研究。纳入研究均在患者应用新型口服抗血小板药物后采集了吗啡应用和血小板活性相关性资料。对比吗啡应用者和未应用者的HPPR。

结果显示，吗啡未应用者的残留血小板活性降低程度较应用者更为迅猛，并且在第1、2和4小时具有统计学意义，但8小时后两组患者的血小板活性基本一致。呕吐以及胃肠道通过时间延迟可能为抗血小板药物效应延迟的原因;但即使在没有呕吐的患者中，这种相关性仍存在。对多因素进行校正之后，吗啡应用与抗血小板药负荷剂量用药2小时后HPPR升高3倍以上具有相关性，并且替卡格雷和氯吡格雷均为如此。

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    2014-06-01 tomyang98

    #EuroPCR#

    0

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    2014-06-25 shizhenshan

    #抗血小板药#

    0

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    2014-05-29 showtest

    #吗啡#

    0

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    2014-05-29 Tommy1950

    #PCR#

    0

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