氯吡格雷联合低分子肝素钠治疗中老年急性冠脉综合征的疗效观察

摘要

Objective To analyze the effect of clopidogrel combined with low molecular weight heparin on the treatment of middle-aged and elderly patients with acute coronary syndrome.Methods Totally 94 patients with acute coronary syndrome were selected and randomly divided into control group and observation group,47 cases in each group.The patients in the control group were given clopidogrel,while patients in the observation group were given clopidogrel combined with low molecular weight heparin sodium.The clinical efficacy,platelet aggregation rate,drug safety and cardiac function improvement were observed and compared between the two groups before and after treatment.Results The total effective rate in the observation group was 93.62％,which was significantly higher than 78.72％ in the control group (P ＜ 0.05).Mter the treatment for 1 and 2 weeks,the platelet aggregation rate in the observation group was significantly lower than that in the control group (P ＜ 0.05).After the treatment,LVEDD and LVESD levels in both groups were significantly lower than those before treatment,LEVF level was significantly higher than that before treatment,LVEDD and LVESD levels in the observation group were significantly lower than those in the control group,and LEVF level was significantly higher than the control group (P ＜ 0.05).There was no significant differences between the two groups in the incidence rates of bleeding,gastrointestinal reactions,headache and rash (P ＞ 0.05).Conclusion Clopidogrel combined with low molecular weight heparin is effective in the treatment of middle-aged and elderly patients with acute coronary syndrome,which can effectively reduce the platelet aggregation rate,enhance cardiac function and exercise tolerance,reduce the risk of sudden death and improve prognosis.%目的 分析氯吡格雷联合低分子肝素钠治疗中老年急性冠脉综合征的疗效.方法 选择94例急性冠状动脉综合征患者,随机分为对照组、观察组各47例.对照组服用氯吡格雷治疗,观察组给予氯呲格雷联合低分子肝素钠治疗.比较2组疗效、血小板聚集率、用药安全性以及心功能改善情况.结果 观察组治疗总有效率为93.62％,显著高于对照组的78.72％ (P ＜0.05).治疗1、2周后,观察组血小板聚集率均显著低于对照组(P＜0.05).治疗后,2组左室舒张末内径(LVEDD)及左室收缩末内径(LVESD)水平均显著低于治疗前,左室射血分数(LVEF)水平显著高于治疗前,且观察组LVEDD及LVESD水平显著低于对照组,LEVF水平显著高于对照组(P＜0.05).2组出血、胃肠道反应、头痛、皮疹等不良反应发生率对比,差异无统计学意义(P＞0.05).结论 氯吡格雷联合低分子肝素钠治疗中老年急性冠脉综合征疗效显著,可有效降低血小板聚集率,增强患者心功能及运动耐力,降低猝死风险,改善预后.