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

摘要

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 .%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。