不同剂量氯吡格雷治疗急性ST段抬高心肌梗死的疗效及安全性分析  

Effectiveness and Safety of Different Doses of Clopidogrel in Patients with Acute ST-segment Elevation Myocardial Infarction

作　　者：王渊铭[1] 陈德[1] 黄晴[1] 王蕊[1] 姚建华[1] 

机构地区：[1]同济大学附属上海市杨浦区中心医院心内科,上海200090

出　　处：《现代生物医学进展》2012年第18期3505-3507,3493,共4页Progress in Modern Biomedicine

摘　　要：目的:探讨不同剂量氯吡格雷治疗急性ST段抬高心肌梗死(STEMI)的疗效及安全性。方法:178例急性STEMI患者随机分为高剂量组和常规剂量组,每组各69例。两组均给予阿司匹林、静脉溶栓、抗凝及降脂等常规治疗,高剂量组和常规剂量组分别口服氯吡格雷负荷量600 mg、300 mg,之后两组患者给予维持量75 mg/d。结果:治疗30 d后,高剂量组总有效率为91.0%,常规剂量组为77.5%,差异有统计学意义(P<0.05);高剂量组治疗后36 h及30d的MACE发生率为3.4%和6.7%,常规剂量组为12.4%和18.0%,差异均有统计学意义(P<0.05);两组出血发生率分别为9.0%,5.6%,差异无统计学意义(P>0.05)。结论:高剂量(600 mg)氯吡格雷治疗急性STEMI疗效优于常规剂量(300 mg),且具有良好的安全性。Objective： To explore the clinical effect and safety of different doses of clopidogrel on the treatment of acute ST-segment elevation myocardial infarction （STEMI）. Methods： 178 patients with acute STEMI were randomly divided into two groups. All the cases were given aspirin, intravenous thrombolysis, anticoagulants, lipid-lowering and so on. The patients respectively received 600 mg （high dose group, n=89） and 300 mg （normal dose group, n=89） loading dose of clopidogrel administration, followed by the maintenance dose of 75 mg/d. Result： The total effect rate of high dose group and normal dose group were 91.0% and 77.5%, the difference was statistically significant （P〈0.05）. The MACE rates within 24 hours（3.4% vs. 12.4%）and 30 days（6.7% vs. 18.0%） in high dose group were significantly lower than those in normal dose group （P〈0.05）. The rate of bleeding in high dose and normal dose group was 9.0% and 5.6%, respectively, with no significantly difference （P〉0.05）. Conclusions： High dose treatment of clopidogrel （600 mg） is better than normal dose treatment （300 mg） in acute STEMI and both methods have good safety.

关 键 词：氯吡格雷 急性ST段抬高心肌梗死 剂量 

分 类 号：R542.22[医药卫生—心血管疾病]