氯吡格雷对急性前壁性心肌梗死患者PCI的疗效及安全性分析

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目的:探讨氯吡格雷在急性前壁性心肌梗死患者行经皮冠脉介入术(PCI)中应用的效果及安全性。方法:选取2013年1月~2015年1月本院收治的80例急性前壁性心肌梗死并行PCI手术患者,采用随机数字表法分为A、B组各40例,患者入院后首次均给予负荷剂量的氢氯吡格雷600 mg,之后A组给予氢氯吡格雷150 mg·d~(-1)、B组给予75 mg·d~(-1),两组其余治疗相同,氢氯吡格雷维持治疗至PCI术后6个月。结果:入院时,血小板聚集率、血清B型脑钠肽(BNP)比较,A、B两组患者差异不显著(P>0.05);术前及术后3个月,两组患者的血小板聚集率、血清BNP较入院时均显著的降低(P<0.05);术前及术后3个月,A组患者的血小板聚集率、血清BNP显著的低于B组患者(P<0.05);PCI术后,A组TIMI血流分级3级的患者有90%,高于B组患者的80.00%,但差异无统计学意义(P>0.05);术后12个月内,A组患者共有5例(12.50%)患者发生心血管不良事件,与B组的4例(10.00%)差异均无统计学意义(χ~2=0.125,P>0.05)。结论:高维持剂量的氢氯吡格雷在急性前壁性心肌梗死患者行PCI中应用具有降低血小板聚集率和降低BNP的作用,同时并不会增加心血管不良事件的发生率。 Objective: To investigate the efficacy and safety of clopidogrel in patients with acute anterior myocardial infarction undergoing percutaneous coronary intervention (PCI). Methods: A total of 80 patients with acute anterior myocardial infarction (PCI) treated in our hospital from January 2013 to January 2015 were randomly divided into group A and group B (40 cases). Patients were admitted for the first time after admission The loading dose of clopidogrel 600 mg was given 150 mg · d -1 for clopidogrel in group A and 75 mg · d -1 in group B, Gray maintained treatment until 6 months after PCI. Results: At admission, the platelet aggregation rate and serum BNP level were not significantly different between A and B groups (P> 0.05). Preoperative and postoperative 3 months, platelet aggregation (P <0.05). The preoperative and postoperative 3 months, the platelet aggregation rate of patients in group A and the serum BNP were significantly lower than those in group B (P <0.05); PCI Postoperatively, 90% of patients in group A with TIMI grade 3 were 80% higher than those in group B, but the difference was not statistically significant (P> 0.05). Within 12 months after operation, patients in group A had a total of 5 There was no significant difference in the incidence of cardiovascular events between patients (12.50%) and 4 (10.00%) patients in group B (χ ~ 2 = 0.125, P> 0.05). Conclusions: High maintenance dose of clopidogrel in patients with acute anterior myocardial infarction underwent PCI in order to reduce the rate of platelet aggregation and reduce BNP, but did not increase the incidence of cardiovascular adverse events.
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