阿司匹林联合氯吡格雷治疗ST段抬高型急性心肌梗死的临床研究  

Clinical Study of Combine of Clopidogrel and Aspirin Therapy in Patients of Acute Myocardial Infarction with ST-Elevation

作　　者：张言镇[1] 赵丽梅[1] 柳林[1] 赵新祥[1] 蔡跃红[1] 吴玉萍[1] 

机构地区：[1]潍坊医学院附属潍坊市人民医院,山东潍坊261041

出　　处：《潍坊医学院学报》2006年第2期110-114,共5页Acta Academiae Medicinae Weifang

摘　　要：目的观察阿司匹林联合氯吡格雷对ST段抬高的急性心肌梗死(STEMI)患者的治疗作用。方法600例24h以内发病的STEMI患者随机分为A组与B组,在常规治疗急性心肌梗死的基础上,A组给予阿司匹林162mg/d加氯吡格雷75mg/d,B组给予阿司匹林162mg/d加安慰剂,最长治疗28d。观察并记录住院期间发生的心力衰竭、中风、死亡和再发心肌梗死等情况。结果与B组相比,A组治疗后患者死亡、再发心肌梗死与中风等的发生风险减少10%(9.0%vs10.0%,P<0.01);进一步分析发现死亡率减少6.25%(7.5%vs8.0%,P<0.05)。两组副作用比较差异无统计学意义。结论ST段抬高的急性心肌梗死患者在应用阿司匹林标准治疗的基础上加用氯吡格雷75mg/d,可显著降低住院期间的死亡率和心血管事件发生率。Objective To evaluate the clinical effect of combine elopidogrel and aspirin in acute myocardial infarction with ST-elevation（STEMI） patients. Methods Six hundred patients with ST-elevation acute myocardial infarction admitted to hospital within 24 hours were divided into 2 groups randomly： Group A allocated clopidogrel 75mg/d add to aspirin 162mg/d, Group B allocated plaeebo daily add to aspirin 162mg/d. Treatment continue until discharge or up to 4 weeks in hospital. After treatment the two outcome were compared：①the composite of death, stroke and reinfarction; ②death from any cause during the scheduled period. All datas were analysized by SPSSI 1.0 soft ware. Results Compared with group B, patients of group A produced higher significantly 10 % reduction in death, reinfarction or stroke （ 9.0 % vsl 0.0%, P 〈 0.01 ） ; there, was also a significantly 6.25 % reduction in any death （ 7.5 % vs8.0 %, P 〈 0.05 ） . Considering all fatal cerebral bleeding, or other side effects, no significant risk diffience was noted group. Conclusion In a wide range of patients with STEMI, adding elopidogrel 75mg daily to aspirin and other standard AMI treatment can safety reduce the mortality and major cardiovascular events in hospital.

关 键 词：ST段抬高性心肌梗死 阿司匹林 氯吡格雷 心血管事件 

分 类 号：R54[医药卫生—心血管疾病]