早期高負荷劑量氯吡格雷治療急性冠脈綜合征的療效觀察

[摘要] 目的 分析早期高負荷劑量氯吡格雷治療急性冠脈綜合征的療效。 方法 選擇未進行冠脈介入治療的急性冠脈綜合征患者176例，隨機分為觀察組和對照組各88例。觀察組采用早期高負荷劑量用藥，對照組采用常規用藥。比較兩組患者用藥后的近期療效和遠期療效。 結果 兩組患者治療前和治療后比較，其血小板聚集率計數差異均無統計學意義（P>0.05）；兩組患者治療后其PAR計數均出現下降，與治療前比較，差異有統計學意義（P<0.05）；除心源性死亡外，觀察組患者1年內的主要心血管不良事件發生率均低于對照組，差異有統計學意義（P<0.05）。 結論 早期高負荷劑量治療急性冠脈綜合征的療效安全可靠。

[關鍵詞] 高負荷劑量；急性冠脈綜合征；療效

[中圖分類號] R541.4 [文獻標識碼] B [文章編號] 2095-0616（2012）22-66-02

Clinical observation in patients with acute coronary syndrome by early high loading dose of clopidogrel

XIA Shuna

Department of Internal Medicine， the Occupation Disease Hospital of Xinjiang Uygur Autonomous Region， Urumqi 830091，China

[Abstract] Objective To analyze the clinical observation of patients with acute coronary syndrome by early high loading dose of clopidogrel. Methods 176 cases with acute coronary syndrome who without coronary intervention were randomly divided into the observation group and the control group， 88 cases in each group. The observation group was treated with early high loading dose of medication， the control group was treated with routine medication. The therapeutic effect of two group patients after administration were compared. Results The two groups were compared before and after treatment， there were no significant differences of PAR count between two group （P>0.05 ）； the PAR counts were decreased in two group patients after treatment， compared with treatment before， the difference was statistically significant （P<0.05）； In addition to cardiac death， the major adverse cardiovascular events incidence rate in1 years in the observation group was lower than control group， the difference was statistically significant （P<0.05）. Conclusion Early high loading dose in the treatment of acute coronary syndrome safety and reliable.

[Key words] High loading dose；Acute coronary syndrome；Therapeutic effect

急性冠脈綜合征（acute coronary syndrome，ACS）是包括不穩定型心絞痛和急性心肌梗死在內的一組臨床綜合征。氯吡格雷已經成為ACS治療的常規藥物，可與血小板表面二磷酸腺苷（adenosine diphosphate，ADP）受體結合，進而抑制血小板聚集[1]。本研究旨在探討不同劑量氯吡格雷對ACS患者近期療效和遠期不良反應的影響，以比較其療效的安全性。

1 資料與方法

1.1 一般資料

選擇2011年1～12月筆者所在醫院無法進行冠脈介入治療的ACS患者176例，其中男107例，女69例；年齡52～73歲，平均（59.32±11.37）歲。根據隨機數字表法隨機分為觀察組和對照組各88例。觀察組患者使用早期高負荷劑量氯吡格雷治療，對照組患者使用常規劑量治療。兩組患者在年齡、性別、血壓、心率及心功能等一般情況比較，差異無統計學意義（P>0.05），具有可比性。……