氯吡格雷联合阿司匹林治疗急性心肌梗死的临床效果观察(1)
【摘 要】目的:探讨氯吡格雷联合阿司匹林治疗急性心肌梗死的临床效果。方法:收集2016年9月至2018年3月入院的96例急性心肌梗死患者,随机分为试验组与对照组各48例,对照组患者给予阿司匹林治疗,试验组患者给予氯吡格雷联合阿司匹林治疗,比较两组患者血管再通率、血管再闭塞率、心血管事件发生率、治疗后血小板聚集率、凝血指标及左心室射血分数。结果:试验组患者血管再通率高于对照组,血管在闭塞率、心血管事件发生率低于对照组,存在明显差异(P<0.05);治疗后血小板聚集率低于对照组,左心室射血分数高于对照组,存在显著性差异(P<0.01);治疗后两组凝血指标无统计学差异(P>0.05)。结论:急性心肌梗死患者的抗血小板治疗中,氯吡格雷联合阿司匹林抗血小板效果更好,有效减少心血管事件的发生,疗效确切,值得推广应用。
【关键词】氯吡格雷;阿司匹林;急性心肌梗死;抗血小板
[Abstract] Objective:To explore the clinical effect of clopidogrel combined with aspirin in the treatment of acute myocardial infarction.Method:96patients with acute myocardial infarction admitted from September2016to March2018were randomly divided into48cases in the experimental group and the control group.The patients in the control group were treated with aspirin.The patients in the test group were treated with clopidogrel and aspirin.The rate of repassage, reocclusion and the incidence of cardiovascular events in the two groups were compared.And platelet aggregation rate, coagulation index and left ventricular ejection fraction after treatment.Result:The rate of blood vessel repassage in the experimental group was higher than that of the control group.The incidence of vascular occlusion rate and cardiovascular events was lower than that of the control group (P<0.05).After treatment, the platelet aggregation rate was lower than that of the control group.The left ventricular ejection fraction was higher than the control group (P<0.01); after treatment, the blood coagulation indexes were not unified.Study difference (P>0.05).Conclusion:In the antiplatelet therapy of acute myocardial infarction, clopidogrel combined with aspirin has better antiplatelet effect, effectively reducing the occurrence of cardiovascular events, and it is effective and worthy of application.
[Key words] clopidogrel; aspirin; acute myocardial infarction; antiplatelet.
【中圖分类号】R73 【文献标识码】B 【文章编号】2095-6851(2018)08--01
急性心肌梗死(AMI)是指急性的心肌缺血性坏死,通常再冠状动脉病变的基础上而发生的冠脉血供急剧减少或中断,导致相应的心肌严重而持久的急性缺血[1]。本病欧美常见,但随着生活水平的提高,近年来我国AMI发病率也呈逐年上升的趋势。本病大多数与冠脉的粥样斑块有关,因此抗血小板治疗是本病的重要治疗手段,可有效防止血栓形成,预防血管阻塞性病变的发展,改善预后,预防冠脉及脑动脉血栓栓塞[2]。常用的药物为阿司匹林,其他药物有氯吡格雷、替格瑞洛、普拉格雷等。本研究为探讨氯吡格雷联合阿司匹林治疗急性心肌梗死患者的临床效果,对我院96例急性心肌梗死患者进行临床观察,现报道如下:
1 资料与方法
1.1 一般资料
收集2016年9月至2018年3月入院的96例急性心肌梗死患者随机分为观察组37例,对照组36例。所有患者均符合《中国心血管病预防指南(2017版)》[3]的相关诊断标准。排除标准:(1)对阿司匹林、氯吡格雷、低分子肝素等药物不耐受者;(2)血小板计数过高或过低者;(3)血红蛋白<100g/L者;(4)NYHA分级Ⅲ级或Ⅳ级者;(5)肝、肾功能不全、活动性消化道溃疡、严重感染、恶性肿瘤者;(6)变异性心绞痛、心源性休克或恶性心律失常者;(7)6个月内有脑卒中病史,3个月内有手术史者;(8)血液系统疾病、出血性疾病或有出血倾向者;(9)随访资料不全或随访丢失者。其中,观察组患者男25例,女23例,年龄52~77岁,平均年龄为(58.5±4.6)岁,ST段抬高型心肌梗死29例,非ST段抬高型心肌梗死19例;对照组患者男24例,女24例,年龄50~75岁,平均年龄为(57.6±3.7)岁,ST段抬高型心肌梗死30例,非ST段抬高型心肌梗死18例。两组患者性别、年龄、病种等一般情况的差异无统计学意义,具有可比性(P>0.05)。所有患者均同意本研究,签订知情同意书,所有治疗及护理符合医疗操作常规。 (韦姬)
【关键词】氯吡格雷;阿司匹林;急性心肌梗死;抗血小板
[Abstract] Objective:To explore the clinical effect of clopidogrel combined with aspirin in the treatment of acute myocardial infarction.Method:96patients with acute myocardial infarction admitted from September2016to March2018were randomly divided into48cases in the experimental group and the control group.The patients in the control group were treated with aspirin.The patients in the test group were treated with clopidogrel and aspirin.The rate of repassage, reocclusion and the incidence of cardiovascular events in the two groups were compared.And platelet aggregation rate, coagulation index and left ventricular ejection fraction after treatment.Result:The rate of blood vessel repassage in the experimental group was higher than that of the control group.The incidence of vascular occlusion rate and cardiovascular events was lower than that of the control group (P<0.05).After treatment, the platelet aggregation rate was lower than that of the control group.The left ventricular ejection fraction was higher than the control group (P<0.01); after treatment, the blood coagulation indexes were not unified.Study difference (P>0.05).Conclusion:In the antiplatelet therapy of acute myocardial infarction, clopidogrel combined with aspirin has better antiplatelet effect, effectively reducing the occurrence of cardiovascular events, and it is effective and worthy of application.
[Key words] clopidogrel; aspirin; acute myocardial infarction; antiplatelet.
【中圖分类号】R73 【文献标识码】B 【文章编号】2095-6851(2018)08--01
急性心肌梗死(AMI)是指急性的心肌缺血性坏死,通常再冠状动脉病变的基础上而发生的冠脉血供急剧减少或中断,导致相应的心肌严重而持久的急性缺血[1]。本病欧美常见,但随着生活水平的提高,近年来我国AMI发病率也呈逐年上升的趋势。本病大多数与冠脉的粥样斑块有关,因此抗血小板治疗是本病的重要治疗手段,可有效防止血栓形成,预防血管阻塞性病变的发展,改善预后,预防冠脉及脑动脉血栓栓塞[2]。常用的药物为阿司匹林,其他药物有氯吡格雷、替格瑞洛、普拉格雷等。本研究为探讨氯吡格雷联合阿司匹林治疗急性心肌梗死患者的临床效果,对我院96例急性心肌梗死患者进行临床观察,现报道如下:
1 资料与方法
1.1 一般资料
收集2016年9月至2018年3月入院的96例急性心肌梗死患者随机分为观察组37例,对照组36例。所有患者均符合《中国心血管病预防指南(2017版)》[3]的相关诊断标准。排除标准:(1)对阿司匹林、氯吡格雷、低分子肝素等药物不耐受者;(2)血小板计数过高或过低者;(3)血红蛋白<100g/L者;(4)NYHA分级Ⅲ级或Ⅳ级者;(5)肝、肾功能不全、活动性消化道溃疡、严重感染、恶性肿瘤者;(6)变异性心绞痛、心源性休克或恶性心律失常者;(7)6个月内有脑卒中病史,3个月内有手术史者;(8)血液系统疾病、出血性疾病或有出血倾向者;(9)随访资料不全或随访丢失者。其中,观察组患者男25例,女23例,年龄52~77岁,平均年龄为(58.5±4.6)岁,ST段抬高型心肌梗死29例,非ST段抬高型心肌梗死19例;对照组患者男24例,女24例,年龄50~75岁,平均年龄为(57.6±3.7)岁,ST段抬高型心肌梗死30例,非ST段抬高型心肌梗死18例。两组患者性别、年龄、病种等一般情况的差异无统计学意义,具有可比性(P>0.05)。所有患者均同意本研究,签订知情同意书,所有治疗及护理符合医疗操作常规。 (韦姬)