阿司匹林联合氯吡格雷对急性心肌梗死急诊经皮冠脉介入治疗术后心功能影响  

Effect of Aspirin combined with clopidogrel on Cardiac function of acute myocardial infarction after emergency percutaneous coronary intervention

作　　者：张晓峰[1] 刘刚[1] 张君红[1] 王雪莉[1] ZHANG Xiaofeng, LIU Gang, ZHANG Junhong, WANG Xueli(The first people＇s Hospital of Xinjiang District ofAkesu, Akesu 843000, China)

机构地区：[1]新疆阿克苏地区第一人民医院,新疆阿克苏843000

出　　处：《药物评价研究》2018年第8期1473-1476,共4页Drug Evaluation Research

摘　　要：目的探讨阿司匹林联合氯吡格雷对急性心肌梗死急诊经皮冠脉介入治疗(PCI)术后心功能的影响。方法选择2014年10月—2016年10月,在新疆阿克苏地区第一人民医院急诊科收治的142例急性心肌梗死患者为研究对象,均行PCI术治疗;根据药物治疗方法的不同分为对照组(n=71)和联合组(n=71);对照组术前术后在常规治疗的基础上给予氯吡格雷;联合组在对照组治疗的基础上给予阿司匹林辅助治疗。持续治疗12个月。比较两组的临床效果,两组术后心功能指标及高敏C蛋白含量变化。结果两组术后冠脉造影在梗死部位均无血栓影,同时两组1个月内的治疗总有效率分别为90.14%和81.69%,相比差异无统计学意义。两组术后12个月再血栓发生率分别为1.41%和12.68%,联合组明显低于对照组,差异有统计学意义(P<0.05)。联合组治疗后患者心功能明显优于对照组,差异有统计学意义(P<0.05)。两组在治疗后24 h、72 h、7 d血清hs-CRP含量显著低于治疗前,同组治疗前后比较差异有统计学意义(P<0.05);联合组在治疗后24h、72 h、7 d血清hs-CRP含量显著低于对照组,差异有统计学意义(P<0.05)。结论阿司匹林联合氯吡格雷可有效减少PCI术后再血栓的发生,改善急性术后心功能的恢复,降低机体炎性免疫反应。Objective To investigate the Effect of Aspirin combined with clopidogrel on Cardiac function of Acute Myocardial Infarction after Emergency Percutaneous coronary intervention. Methods From October 2014 to October 2016, 142 patients with acute myocardial infarction were treated in the emergency department of our hospital were considered as objects. According to the treatment methods, all patients were divided into control group（n =71） and combined group（n = 71）; the control group underwent Clopidogrel on the basis of routine treatment, at preoperative and postoperative. The combined group were given Aspirin adjuvant therapy on the basis of control group. The clinical effect and adverse reaction after medication were compared between the two groups. The changes of cardiac function index and high sensitive c protein content in the two groups after operation were compared. Results There was no thrombus in the infarct site in the two groups after the operation. The total effective rate of control group and combined group were respectively 90.14% and 81.69 at first month. There was no significant difference between the two groups. In two groups after operation 12 months, the incidence rate of thrombosis were 1.41% and 12.68%, the combined group was significantly lower than the control group（P〈0.05）. The cardiac function of the combined group after treatment was better than the control group（P〈0.05）. After treatment 24 h, 72 h and 7 d, the serum hs-CRP content in the combined group was significantly lower than the control group（P〈0.05）. Conclusion Aspirin combined with clopidogrel can effectively reduce the occurrence of re-thrombosis after PCI, improve the recovery of cardiac function, and reduce the inflammatory immune response.

关 键 词：急性心肌梗塞 阿司匹林 氯吡格雷 

分 类 号：R969.4[医药卫生—药理学]