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

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。

原始出处:


版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (4)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1746865, encodeId=09c21e4686554, content=<a href='/topic/show?id=1fb7e08974' target=_blank style='color:#2F92EE;'>#EuroPCR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7089, encryptionId=1fb7e08974, topicName=EuroPCR)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4b4735868574, createdName=tomyang98, createdTime=Sun Jun 01 15:21:00 CST 2014, time=2014-06-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2032534, encodeId=358a2032534f1, content=<a href='/topic/show?id=e00855e5387' target=_blank style='color:#2F92EE;'>#抗血小板药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55753, encryptionId=e00855e5387, topicName=抗血小板药)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ccbd84, createdName=shizhenshan, createdTime=Wed Jun 25 11:21:00 CST 2014, time=2014-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1346516, encodeId=c3731346516da, content=<a href='/topic/show?id=2013391531d' target=_blank style='color:#2F92EE;'>#吗啡#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39153, encryptionId=2013391531d, topicName=吗啡)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f0715, createdName=showtest, createdTime=Thu May 29 02:21:00 CST 2014, time=2014-05-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1419359, encodeId=421c141935936, content=<a href='/topic/show?id=e290138682e' target=_blank style='color:#2F92EE;'>#PCR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13868, encryptionId=e290138682e, topicName=PCR)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9cc43496966, createdName=Tommy1950, createdTime=Thu May 29 02:21:00 CST 2014, time=2014-05-29, status=1, ipAttribution=)]
    2014-06-01 tomyang98
  2. [GetPortalCommentsPageByObjectIdResponse(id=1746865, encodeId=09c21e4686554, content=<a href='/topic/show?id=1fb7e08974' target=_blank style='color:#2F92EE;'>#EuroPCR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7089, encryptionId=1fb7e08974, topicName=EuroPCR)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4b4735868574, createdName=tomyang98, createdTime=Sun Jun 01 15:21:00 CST 2014, time=2014-06-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2032534, encodeId=358a2032534f1, content=<a href='/topic/show?id=e00855e5387' target=_blank style='color:#2F92EE;'>#抗血小板药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55753, encryptionId=e00855e5387, topicName=抗血小板药)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ccbd84, createdName=shizhenshan, createdTime=Wed Jun 25 11:21:00 CST 2014, time=2014-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1346516, encodeId=c3731346516da, content=<a href='/topic/show?id=2013391531d' target=_blank style='color:#2F92EE;'>#吗啡#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39153, encryptionId=2013391531d, topicName=吗啡)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f0715, createdName=showtest, createdTime=Thu May 29 02:21:00 CST 2014, time=2014-05-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1419359, encodeId=421c141935936, content=<a href='/topic/show?id=e290138682e' target=_blank style='color:#2F92EE;'>#PCR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13868, encryptionId=e290138682e, topicName=PCR)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9cc43496966, createdName=Tommy1950, createdTime=Thu May 29 02:21:00 CST 2014, time=2014-05-29, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1746865, encodeId=09c21e4686554, content=<a href='/topic/show?id=1fb7e08974' target=_blank style='color:#2F92EE;'>#EuroPCR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7089, encryptionId=1fb7e08974, topicName=EuroPCR)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4b4735868574, createdName=tomyang98, createdTime=Sun Jun 01 15:21:00 CST 2014, time=2014-06-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2032534, encodeId=358a2032534f1, content=<a href='/topic/show?id=e00855e5387' target=_blank style='color:#2F92EE;'>#抗血小板药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55753, encryptionId=e00855e5387, topicName=抗血小板药)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ccbd84, createdName=shizhenshan, createdTime=Wed Jun 25 11:21:00 CST 2014, time=2014-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1346516, encodeId=c3731346516da, content=<a href='/topic/show?id=2013391531d' target=_blank style='color:#2F92EE;'>#吗啡#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39153, encryptionId=2013391531d, topicName=吗啡)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f0715, createdName=showtest, createdTime=Thu May 29 02:21:00 CST 2014, time=2014-05-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1419359, encodeId=421c141935936, content=<a href='/topic/show?id=e290138682e' target=_blank style='color:#2F92EE;'>#PCR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13868, encryptionId=e290138682e, topicName=PCR)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9cc43496966, createdName=Tommy1950, createdTime=Thu May 29 02:21:00 CST 2014, time=2014-05-29, status=1, ipAttribution=)]
    2014-05-29 showtest
  4. [GetPortalCommentsPageByObjectIdResponse(id=1746865, encodeId=09c21e4686554, content=<a href='/topic/show?id=1fb7e08974' target=_blank style='color:#2F92EE;'>#EuroPCR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7089, encryptionId=1fb7e08974, topicName=EuroPCR)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4b4735868574, createdName=tomyang98, createdTime=Sun Jun 01 15:21:00 CST 2014, time=2014-06-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2032534, encodeId=358a2032534f1, content=<a href='/topic/show?id=e00855e5387' target=_blank style='color:#2F92EE;'>#抗血小板药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55753, encryptionId=e00855e5387, topicName=抗血小板药)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ccbd84, createdName=shizhenshan, createdTime=Wed Jun 25 11:21:00 CST 2014, time=2014-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1346516, encodeId=c3731346516da, content=<a href='/topic/show?id=2013391531d' target=_blank style='color:#2F92EE;'>#吗啡#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39153, encryptionId=2013391531d, topicName=吗啡)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8f0715, createdName=showtest, createdTime=Thu May 29 02:21:00 CST 2014, time=2014-05-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1419359, encodeId=421c141935936, content=<a href='/topic/show?id=e290138682e' target=_blank style='color:#2F92EE;'>#PCR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13868, encryptionId=e290138682e, topicName=PCR)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9cc43496966, createdName=Tommy1950, createdTime=Thu May 29 02:21:00 CST 2014, time=2014-05-29, status=1, ipAttribution=)]
    2014-05-29 Tommy1950