中文摘要：

我们寻求了在离开泵以后估计阿司匹林抵抗的发生冠的动脉绕过(OPCAB ) 外科，并且调查 clopidogrel 是否能改进阿司匹林反应并且安全地在 OPCAB 外科以后早被使用。经历了标准 OPCAB 外科的六十个病人被使随机化进二个组。一个组(30 个病人) 与阿司匹林 100   接受了 mono-antiplatelet 治疗(MAPT ) ； mg 日报和另外的组与阿司匹林 100   接受了双 antiplatelet 治疗(DAPT ) ；加 clopidogrel 的 mg 日报 75  ； mg 日报。响应 arachidonic 酸的血小板聚集(PL _AA ) 和腺苷 diphosphate (自动数据处理)(PL _{自动数据处理} ) 外科手术前地被测量，在天， 1 ～ 6， 8 和 10 在 antiplatelet 代理人以后被管理。PL _{超过 20% 的 AA} 水平被定义为阿司匹林抵抗。手术后的流血和另外的 perioperative 变量也被记录。在基线特征的二个组之间没有重要差别，远侧的吻合的平均数字，操作时间，手术后的流血，通风时间和手术后的医院留下来。然而，阿司匹林抵抗的发生比在在在 antiplatelet 以后的第一和第二天的 MAPT 组，代理人被给的在 DAPT 组是显著地更低的(62.1% 对 32.1% ， 34.5% 对 10.7% ，分别地两 P <；0.05 ) 。在在二个组之间的手术后的复杂并发症没有重要差别。有阿司匹林和 clopidogrel 的 DAPT 能安全地在过程以后早被用于 OPCAB 病人。而且， clopidogrel 减少 OPCAB 相关的阿司匹林抵抗的发生。

英文摘要：

We sought to assess the incidence of aspirin resistance after off-pump coronary artery bypass （OPCAB） surgery, and investigate whether clopidogrel can improve aspirin response and be safely applied early after OPCAB surgery. Sixty patients who underwent standard OPCAB surgery were randomized into two groups. One group （30 patients） received mono-antiplatelet treatment （MAPT） with aspirin 100 mg daily and the other group received dual anfiplatelet treatment （DAPT） with aspirin 100 mg daily plus clopidogrel 75 mg daily. Platelet aggregations in response to arachi- donic acid （PLAA） and adenosine diphosphate （ADP） （PLADP） were measured preoperatively and on days 1 to 6, 8 and 10 after the antiplatelet agents were administered. A PLAA level above 20% was defined as aspirin resistance. Postoperative bleeding and other perioperative variables were also recorded. There were no significant differences between the two groups in baseline characteristics, average number of distal anastomosis, operation time, postoperative bleeding, ventilation time and postoperative hospital stay. However, the incidence of aspirin resistance was significantly lower in the DAPT group than that in the MAPT group on the first and second day after antiplatelet agents were given （62.1% vs, 32.1%, 34.5% vs. 10.7%, respectively, both P 〈 0.05）. There was no significant difference in postoperative complication between the two groups. DAPT with aspirin and clopidogrel can be safely applied to OPCAB patients early after the procedure. Moreover, clopidogrel reduces the incidence of OPCAB-related aspirin resistance.