Objective To research the variance of the platelet aggregation ratio after using ticagrelor instead of clopi-dogrel in patients with clopidogrel resistance. Methods Adenosine diphosphate( ADP)induced platelet aggregation ratio test was run to identify patients with clopidogrel resistance in 512 patients undergoing the treatment of percutaneous coronary interven-tion( PCI)and clopidogrel 75 mg/d. 88 patients with clopidogrel resistance were given randomly clopidogrel 75 mg/d or ticagrelor (90 mg twice a day)for 7 days and took the test of the platelet aggregation ratio after the treatment. Results Aftertreatment for ti-cagrelor group compared with clopidogrel platelet aggregation rate low〔(43. 3 ± 8. 2)% vs. (56. 9 ± 5. 3)%〕,the difference was statistically significant ( P ﹤0. 05 );for the ticagrelor group, platelet aggregation rate decrease than clopidogrel group〔(16. 4 ±9. 8)% vs. (1. 1 ± 4. 1)%〕,the difference is statistically significant(P﹤0. 05);for the the ticagrelor group, platelet aggregation rate compliance rate than clopidogrel group was higher(84. 4% vs. 4. 7%),the difference was statistically significant(P﹤0. 05);for the ticagrelor group and clopidogrel group in the course of the experiment showed no major bleed-ing. Conclusion Ticagrelor,comparing the regular-dose treatment of clopidogrel,can decrease the platelet aggregation ratio in patients with clopidogrel resistance.%目的：探讨在治疗氯吡格雷抵抗患者时，将氯吡格雷更换为替格瑞洛后血小板聚集率的变化情况。方法选择正在应用氯吡格雷75 mg/d治疗的经皮冠状动脉介入治疗（ PCI）术后患者512例，用比浊法测定血小板聚集率，根据血小板聚集率筛选出氯吡格雷抵抗患者88例。然后将这88例患者1：1随机分为氯吡格雷组及替格瑞洛组，氯吡格雷组继续服用氯吡格雷（75 mg/d），替格瑞洛组将氯吡格雷（75 mg/d）更换为替格瑞洛（90 mg，2次/d）。随访7d，主要观察7d前后血小板聚集率的变化，同时观察7d内出血发生率。结果治疗后替格瑞洛组较氯吡格雷组血小板聚集率低〔（43.3±8.2）%比（56.9±5.3）%〕，差异有统计学意义（P﹤0.05）；替格瑞洛组血小板聚集率下降值较氯吡格雷组大〔（16.4±9.8）%比（1.1±4.1）%〕，差异有统计学意义（ P﹤0.05）；替格瑞洛组血小板聚集率达标率较氯吡格雷组高（84.4%比4.7%），差异有统计学意义（ P﹤0.05）；替格瑞洛组及氯吡格雷组在试验过程中均无主要出血。结论对于氯吡格雷抵抗患者，将氯吡格雷更换为替格瑞洛后能明显降低血小板聚集率。
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