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目的探讨氯吡格雷联合阿司匹林在治疗非ST段抬高型急性冠状动脉综合征(NSTACS)非介入治疗中的临床效果。方法选择2005年至2007年NSTACS患者中因各种原因未行介入治疗者126例,在常规治疗(扩冠、改善循环、抗凝等)基础上,60例对照组予长期单独口服阿司匹林100mg/d;66例治疗组氯吡格雷(50～75mg/d)联合阿司匹林口服,服用6个月以上。观察2组在急性期以及病后远期(1个月～2年)心脏不良事件的发生情况,评价其临床效果。结果2组患者急性期(3周内)均取得良好效果,心脏不良事件发生率分别为19.7%、25.0%,差异无统计学意义(P>0.05);远期心脏不良事件发生率分别为13.6%、26.7%,差异有统计学意义(P<0.05)。结论强化抗血小板聚集的口服药物治疗(阿司匹林联合氯吡格雷6个月以上)对于有效控制血栓形成、延缓冠状动脉斑块进展、减少急性心脏不良事件的发生具有积极的治疗和预防作用。
Objective To investigate the clinical effects of clopidogrel combined with aspirin in the treatment of non-ST-segment elevation acute coronary syndrome (NSTACS) non-interventional therapy. Methods A total of 126 patients with NSTACS who had not been involved in interventional therapy for various reasons from 2005 to 2007 were enrolled in this study. Sixty control subjects were given long-term oral aspirin 100 mg / d; 66 patients treated with clopidogrel (50 ~ 75mg / d) combined with aspirin orally, taking more than 6 months. The incidence of cardiac adverse events in both acute and post-operative conditions (1 month to 2 years) were observed and the clinical effects were evaluated. Results The acute phase (3 weeks) of both groups achieved good results. The incidence of adverse cardiac events were 19.7% and 25.0% respectively, with no significant difference (P> 0.05). The incidence of long-term cardiac adverse events were 13.6 %, 26.7%, the difference was statistically significant (P <0.05). Conclusions Oral drug therapy (aspirin combined with clopidogrel more than 6 months) to strengthen antiplatelet aggregation has a positive therapeutic and preventive effect on the effective control of thrombosis, delaying the progression of coronary plaque and reducing the incidence of acute cardiac adverse events.