氯吡格雷在非ST段抬高心肌梗死患者冠脉介入治疗中的作用  

Effect of clopidogrel in patients with non ST segment elevation myocardial infarction during emergency percutaneous coronary intervention

作　　者：刘崇韬 郑志虹[2] 

机构地区：[1]佳木斯市中心医院心内一科,黑龙江佳木斯154000 [2]佳木斯大学附属第一医院

出　　处：《心血管康复医学杂志》2015年第2期185-188,共4页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的：探讨氯吡格雷在非ST 段抬高心肌梗死（NSTEMI）患者急诊介入治疗时的应用价值。方法：选择2012年1月～2013年2月于本院治疗的168例NSTEMI患者，随机分为氯吡格雷组（84例）与噻氯匹啶组（84例），均急诊行冠脉介入治疗。观察两组患者的临床疗效并进行对比。结果：术后28d ，与噻氯匹定组比较，氯吡格雷组TIMI 3级血流比例（88.1％比91.7％）、白细胞计数[（4.0±2.9）×109／L比（7.2±2.3）×109／L]、血小板计数[（101±35）×109／L比（141±39 ）×109／L ]明显增多，轻度出血比例（40.5％比19.0％） 显著减少（ P＜0.05或 P＜0.01）；经6个月随访，与噻氯吡啶组比较，氯吡格雷组心血管事件（60.7％比27.4％）、不良反应发生率（14.3％比10.8％） 均明显降低（ P均＜0.05）。结论：氯吡格雷用于非S T 段抬高心肌梗死患者急诊冠脉介入治疗疗效满意，安全性高，值得推广。Objective：To explore the application value of clopidogrel in patients with non ST segment elevation myo‐cardial infarction （NSTEMI） during emergency percutaneous coronary intervention （PCI） .Methods ：A total of 168 NSTEMI patients treated in our hospital from Jan 2012 to Feb 2013 were randomly divided into clopidogrel group （n=84） and ticlopidine group （n=84） ,both groups received PCI .Therapeutic effect were observed and compared be‐tween two groups .Results：Compared with ticlopidine group , there were significant rise in percentage of TIMI blood flow grade 3 （88.1% vs .91.7% ） ,white blood cell counting [ （4.0 ± 2.9） 109/L vs .（7.2 ± 2.3） 109/L] and platelet counting [ （101 ± 35） 109/L vs .（141 ± 39） 109/L] ,and significant reduction in percentage of mild bleeding （40.5% vs .19.0% ） in clopidogrel group after operation 28d , P〈 0.05 or 〈 0.01 ;compared with ticlopidine group , there were significant reductions in incidence rates of cardiovascular events （60.7% vs . 27.4% ） and adverse reactions （14.3% vs .10.8% ） in clopidogrel group after six‐month follow‐up （ P〈0.05 both） .Conclusion：Clopi‐dogrel possesses satisfying therapeutic effect and high safety in patients with non ST segment elevation myocardial in ‐ farction during emergency percutaneous coronary intervention ,which is worth extension .

关 键 词：心肌梗死 血管成形术 气囊 冠状动脉 氯吡格雷 

分 类 号：R541.22[医药卫生—心血管疾病]