氯吡格雷在急性非ST段抬高心肌梗死患者急诊冠状动脉介入治疗中的应用效果

摘要

Objective To evaluate the application effect of clopidogrel during emergency PCI in patients with acute non-ST segment elevation myocardial infarction( NSTEMI). Methods A total of 168 patients with NSTEMI were selected in the First Hospital of Handan from January 2012 to February 2013,and they were randomly divided into study group and control group,each of 84 cases. Both groups received conventional treatment and emergency PCI after admission,and patients of control group were given ticlopidine combined with aspirin during PCI,while patients of study group were given clopidogrel combined with aspirin. Incidence of hemorrhage after 28 days of PCI,incidence of cardiovascular events and adverse reactions during the 9-month follow - up were compared between the two groups. Results TIMI 3 flow rate, WBC, PLT of study group were statistically significantly higher than those of control group after 28 days of PCI(P<0. 05). The incidence of angina pectoris, heart failure,recurrent myocardial infarction,stroke and fatality rate of study group were statistically significantly lower than those of control group during the 9-month follow-up(P<0. 05),while no statistically significant differences of incidence of adverse reactions was found between the two groups(P>0. 05). Conclusion Clopidogrel has a satisfactory application effect during emergency PCI in patients with NSTEMI,which can reduce the risk of hemorrhage and cardiovascular events,without increasing the incidence of adverse reactions.%目的：探讨氯吡格雷在急性非ST段抬高心肌梗死患者急诊冠状动脉介入治疗中的应用效果。方法选取邯郸市第一医院2012年1月—2013年2月收治的急性非ST段抬高心肌梗死患者168例，随机分为研究组和对照组，各84例。两组患者均给予常规治疗及急诊冠状动脉介入治疗，对照组患者急诊冠状动脉介入治疗期间给予噻氯匹定联合阿司匹林治疗，研究组患者给予氯吡格雷联合阿司匹林治疗。观察并记录患者术后28 d出血情况、随访9个月临床心血管事件发生情况及随访期间不良反应发生情况。结果术后28 d，研究组患者TIMI 3级血流率、白细胞计数、血小板计数均高于对照组，轻度出血发生率低于对照组（ P<0.05）。随访9个月时，研究组患者梗死后心绞痛、心力衰竭、再发梗死、脑卒中发生率及病死率均低于对照组（P<0.05）；两组患者随访期间不良反应发生率比较，差异无统计学意义（P>0.05）。结论氯吡格雷应用于非ST段抬高心肌梗死患者急诊冠状动脉介入治疗疗效满意，能减少患者出血倾向，降低心血管事件发生风险，且未增加不良反应发生率。