氯吡格雷对急性前壁性心肌梗死患者PCI的疗效及安全性分析-现代医学

氯吡格雷对急性前壁性心肌梗死患者PCI的疗效及安全性分析

单位：1. 西安医学院第一附属医院药剂科, 陕西西安 710077;
2. 西安市儿童医院药剂科, 陕西西安 710003;
3. 陕西省友谊医院药剂科, 陕西西安 710068

分类号：R473.72

出版年·卷·期（页码）：2017·36·第六期（777-781）

摘要：

目的：探讨氯吡格雷在急性前壁性心肌梗死患者行经皮冠脉介入术（PCI）中应用的效果及安全性。方法：选取2013年1月～2015年1月本院收治的80例急性前壁性心肌梗死并行PCI手术患者，采用随机数字表法分为A、B组各40例，患者入院后首次均给予负荷剂量的氢氯吡格雷600 mg，之后A组给予氢氯吡格雷150 mg·d^-1、B组给予75 mg·d^-1，两组其余治疗相同，氢氯吡格雷维持治疗至PCI术后6个月。结果：入院时，血小板聚集率、血清B型脑钠肽（BNP）比较，A、B两组患者差异不显著（P>0.05）；术前及术后3个月，两组患者的血小板聚集率、血清BNP较入院时均显著的降低（P<0.05）；术前及术后3个月，A组患者的血小板聚集率、血清BNP显著的低于B组患者（P<0.05）；PCI术后，A组TIMI血流分级3级的患者有90%，高于B组患者的80.00%，但差异无统计学意义（P>0.05）；术后12个月内，A组患者共有5例（12.50%）患者发生心血管不良事件，与B组的4例（10.00%）差异均无统计学意义（χ²=0.125，P>0.05）。结论：高维持剂量的氢氯吡格雷在急性前壁性心肌梗死患者行PCI中应用具有降低血小板聚集率和降低BNP的作用，同时并不会增加心血管不良事件的发生率。

Objective: To evaluate the efficacy and safety of clopidogrel in patients with acute anterior wall myocardial infarction undergoing PCI. Methods: Selected January 2013 to January 2015, 80 patients with acute anterior myocardial infarction were enrolled in this study. Using random number table method they were divided into A, B group, 40 cases in each, After the first dose of clopidogrel 600 mg, group A was given clopidogrel 150 mg·d^-1, group B was given 75 mg·d^-1, the remaining treatment of the two groups was the same, lasting for 6 months after PCI. Results: There were no significant differences in platelet aggregation rate and serum BNP between the two groups (P>0.05). The platelet aggregation rate and serum BNP of the two groups were significantly lower than those of the two groups (P<0.05). The platelet aggregation rate, serum BNP was significantly lower than that of group B (P<0.05). After PCI, 90% of patients with TIMI grade 3 were significantly higher in group A than 80.00% in group B, but the difference was not statistically significant (P>0.05). Within 12 months after the operation, there were 5 patients (12.50%) with adverse cardiovascular events in group A, wheras 4 patients (10%) in group B, thus there was no significant difference between group A and group B (χ²=0.125,P>0.05). Conclusion: The use of clopidogrel at a high level in patients with acute anterior wall myocardial infarction with PCI reduces the platelet aggregation rate and decreases BNP, and does not increase the incidence of adverse cardiovascular events.

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