李璐 陈林 周鹏

[摘要] 目的 評价铝镁匹林片（Ⅱ）对稳定型缺血性心脏病患者血小板聚集功能及胃肠道反应。 方法 选取2015年1月～2016年5月在成都医学院第一附属医院心内科就诊需要服用阿司匹林及氯吡格雷双联抗血小板聚集的稳定型缺血性心脏病患者587例为研究对象，依据随机数字表法分成A、B、C三组。A组195例，采用单纯的氯吡格雷治疗；B组196例，采用阿司匹林肠溶片联合氯吡格雷治疗；C组196例，采用铝镁匹林片（Ⅱ）联合氯吡格雷治疗。比较用药前及用药30 d后的血小板聚集率、疗效和不良反应发生率。 结果 经30 d治疗后，三组患者的血小板聚集率均低于用药前（P < 0.05）。三组患者用药后的血小板聚集率不全相同（P < 0.05）。用药后A组的血小板聚集率高于B、C组（P < 0.01）；B组用药后的血小板聚集率与C组比较，差异无统计学意义（P > 0.05）。三组心绞痛疗效差异无统计学意义（P > 0.05）。不良反应事件中，三组心血管不良事件发生率比较，差异无统计学意义（P > 0.05）；C组胃肠不良反应发生率低于A、B组（P < 0.05）。 结论 铝镁匹林片（Ⅱ）对稳定型缺血性心脏病患者具有较好的临床疗效，且胃肠道的不良反应少。

[关键词] 铝镁匹林片（Ⅱ）；阿司匹林肠溶片；稳定型缺血性心脏病；血小板聚集

[中图分类号] R541 [文献标识码] A [文章编号] 1673-7210（2018）10（b）-0058-04

[Abstract] Objective To evaluate the effect of Aluminum-Magnesium and Aspirin Tablets （Ⅱ） on the platelet aggregation function and gastrointestinal reaction for stable ischemic heart disease. Methods A total of 587 patients with stable ischemic heart disease requiring Aspirin and Clopidogrel dual antiplatelet aggregation treated in the Department of Cardiology， the First Affiliated Hospital of Chengdu Medical College from January 2015 to May 2016 were selected. They were divided into A， B， C group. 195 cases of group A were treated with Clopidogrel， 196 cases of group B were treated with Aspirin and Clopidogrel， and 196 cases of group C were treated with Aluminum-Magnesium and Aspirin Tablets （Ⅱ）. The platelet aggregation rate， efficacy before and after 30 days′ treatment， incidence of adverse reactions were compared among the three groups. Results The platelet aggregation rate after 30 days′ treatment of the three groups were lower than that before treatment （P < 0.05）. After treatment， the platelet aggregation rate among the three groups were statistically different （P < 0.05）. After treatment， the platelet aggregation rate in group A was higher than that in group B and C （P < 0.01）； while the platelet aggregation rate had no difference between group B or C （P > 0.05）. The treatment effect of all groups of anginas had no statistically significant difference （P > 0.05）. There was no significant difference in the incidence of cardiovascular adverse events among the three groups （P> 0.05）. The incidence of gastrointestinal adverse reactions was lower in group C than that in groups A and B （P < 0.05）. Conclusion Aluminum-Magnesium and Aspirin Tablets （Ⅱ） has good clinical efficacy in patients with stable ischemic heart disease， and have fewer gastrointestinal adverse reactions.

[Key words] Aluminum-magnesium and aspirin tablets （Ⅱ）； Aspirin enteric-coated tablets； Stable ischemic heart disease； Platelet aggregation

稳定型缺血性心脏病（SIHD）通常是由于冠状动脉粥样硬化导致冠状动脉血流减少引起心肌缺血为特征的一种疾病，可伴有心绞痛、心肌缺血、心肌重构、心力衰竭和心律失常等症状，严重可导致死亡[1]。SIHD患者需长期服用抗血小板药物，其中阿司匹林与氯吡格雷是常用组合，但二者均会引起胃黏膜损伤，影响患者长期使用[2]。铝镁匹林片（Ⅱ）为阿司匹林复方制剂，含有主药阿司匹林81 mg与制酸剂甘羟铝11 mg和重质碳酸镁22 mg，可减轻阿司匹林的胃肠道不良反应。为筛选治疗SIHD最佳药……