氯吡格雷联合阿司匹林对急性冠脉综合征PCI术后血小板聚集功能及预后的影响  

Effect of Ciopidogrel and aspirin on platelet aggregation and prognosis in patients with acute coronary syndrome PCI postoperative

作　　者：王桂芳[1] 刘伟利[1] 李艳琴[1] 

机构地区：[1]河南新乡市第一人民医院心内科,453000

出　　处：《中国临床实用医学》2010年第9期80-82,共3页China Clinical Practical Medicine

摘　　要：目的观察氯吡格雷联合阿司匹林对急性冠脉综合征（ACS）并冠状动脉支架置人术（PCI）后患者血小板聚集功能及预后的影响。方法选择100例ACS并PCI术后患者随机分为两组，所有患者PCI术后常规给予阿司匹林、皮下注射低分子肝素钙及对症治疗，联合组50例加用氯比格雷75mg，1次／d；对照组50例加用安慰剂。两组疗程均为12个月。观察两组在30d内不同时问段血小板聚集率及12个月内血管再闭塞事件的发生情况。结果服药后30d内2组不同时间段血小板聚集率较治疗前均逐渐降低，联合组不同时间段血小板聚集率均显著低于对照组（P均〈0．05）；服药后12个月内联合组死亡率显著低于对照组（P〈0．05）；联合组血管再闭塞事件发生率显著低于对照组（P〈0．05）。两组均未发生严重的不良反应，两组不良反应发生率差异无统计学意义。结论氯吡格雷联合阿司匹林抑制血小板聚集的功能显著强于单用阿司匹林，能显著降低PCI术后死亡率，减少血管再闭塞事件，且不增加患者出血事件的发生。Objective To observate the Effect of Clopidogrel and aspirin on platelet aggregation and prognosis in patients with acute coronary syndrome PCI postoperative. Methods 100 patients with ACS and PCI patients were randomly divided into two groups, After PCI surgery, all patients were given regular aspirin, subcutaneous injection of low molecular weight heparin and symptomatic treatment, the combination group of 50 patients received additional clopidogrel 75 mg, 1 times/d ; the control group of 50 patients were given placebo. 2 groups were treated for 12 months. To observate the platelet aggregation rate of two groups in 30 d at different time and the vascular reocclusion event occurrence in 12 months. Results After medication 30 d,the platelet aggregation of two groups in different time was decreased than before treatment, the platelet aggregation of the combination group at different time were significantly lower than the control group （ P all 〈 0. 05 ） ; the death of the combination group was significantly lower than that of the control group in 12 months （P 〈 0. 05） ; the vas- cular re-occlusion events of the combination group were significantly lower than that of the control group （ P 〈 0. 05 ）. Both groups no serious adverse events, Both groups adverse events was no significant difference. Conclusion The inhibition of platelet aggregation function of Clopidogrel and aspirin was significantly stronger than the single aspirin,it can significantly reduce the PCI postoperative mortality, reduce blood vessel occlusion, and not to increase the patient bleeding events.

关 键 词：急性冠脉综合征 经皮冠状动脉介入治疗 氯吡格雷 阿司匹林 血小板 

分 类 号：R541.4[医药卫生—心血管疾病]