非ST抬高急性冠脉综合征患者经皮冠脉介入治疗术后氯吡格雷使用方法的探讨  

Inve STigation of Discontinuation Methods of Clopidogrel after Percutaneous Coronary Intervention in Non-ST-segment Elevation Acute Coronary Syndromes Patients

作　　者：杨军[1] 程文伟[1] 

机构地区：[1]山东省枣庄市立医院急诊科,277102

出　　处：《实用心脑肺血管病杂志》2009年第2期83-85,共3页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的探讨非ST抬高急性冠脉综合征(NSTACS)患者经皮冠脉介入治疗术(PCI)后氯吡格雷用药的方法。方法选择我院符合标准的NSTACS患者75例,分成两组,A组42例服用氯吡格雷(波立维)75mg/d,12个月后停用,为直接停药组;B组33例服用氯吡格雷75mg/d,12个月后改为37.5mg/d,2周后停药,为渐停药组。检测两组患者在停(减)药前、停(减)药后2周的高敏C-反应蛋白(hs-CRP)。结果两组患者的hs-CRP水平停(减)药前差异无统计学意义(P>0.05),A组停(减)药2周后与停(减)药前差异有统计学意义(P<0.01)。两组患者的hs-CRP水平停(减)药2周后差异有统计学意义(P<0.05)。两组PCI术后12个月主要不良心血管事件间差异无统计学意义(P>0.05)。结论氯吡格雷长期与阿司匹林等合用能够持续降低炎症水平,渐停法优于直接停药法。Objective To inveSTigate the appropriate methods of adminiSTration and discontinuation of elopidogrel in patients with non -ST- segment elevation acute coronary syndromes after pereutaneous coronary intervention （PCI）. Methods 75 patients with non - ST - segment elevation acute coronary syndromes, who received PCI and STandard medical therapy after admission, were divided into two groups. After discharge from hospital, the patients in group A （n = 42） received clopidogrel at 75mg/d for 12 months, and then STopped this drag; the patients in group B （n =33） firSTly received clopidogrel at 75mg/d for 12 months, and then took 37. 5mg/d for 2 weeks. We measured the levels of high sensitive C reaction protein （ hs - CRP） of the patients at the end of 12 months after receiving clopidogrel and 2 weeks after discontinuation or decrease. Results Compared with group A, the levels of hs - CRP in group B had no significantly differences at the end of 12 months; however, they were higher after further 2 weeks （ group A, P 〈 0. 05 ; group B, P 〉 0. 05 ）. and they were significantly higher in group A than those in group B （ P 〈0. 01 ）. Conclusion The adminiSTration of elopidogrel plus aspirin for a long term can decrease the serum inflammation level, and decrease of the dose of clopidogrel gradually is better than discontinuation immediately.

关 键 词：氯吡格雷 急性冠脉综合征 高敏C-反应蛋白 

分 类 号：R543.3[医药卫生—心血管疾病]