摘要Clopidogrel Anergy2003 Germany Müller et at 105 patients with stable coronary artery disease using clopidogrel for PCI,about 5％ of patients showed no response to the drug,which is defined as platelets in the 20 μmol / L ADP under the action of its aggregation only on the basis of the inhibition rate of 10％ or less.These people postoperative thrombosis,showing the drug has resisters,and postoperative thrombosis related.2004 Schr(o) Pat the current proposed clopidogrel " resistance" of the mechanism are summarized as follows:① intestinal absorption function changes:limiting the clopidogrel biotransformation by the liver to form the active metabolite body;② CYP3A4 enzyme changes:Another A possible mechanism is the interference of drugs,some drug-metabolizing cytochrome P450 isoenzymes required with clopidogrel metabolites become an active metabolite compete,which will reduce the antiplatelet effects of clopidogrel,such as atorvastatin (atorvastatin) and erythromycin is required because both cytochrome P4503A4 (CYP3A4) metabolic pathways (Lau,etc.).