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目的观察阿司匹林与氯吡格雷联合应用在冠状动脉慢血流中的治疗效果,研究和评价阿司匹林与氯吡格雷对冠状动脉慢血流的治疗作用。方法通过矫正的TIMI血流分级方法,评价冠状动脉血流速度,对124例冠状动脉慢血流患者随机分为阿司匹林组38例、氯吡格雷组42例、联合组44例,治疗前各组均行平板运动试验及心脏超声左室射血分数(LVEF)测定,治疗1个月后,再次评价冠状动脉血流速度、平板运动试验、心绞痛发作次数。结果三组治疗后在冠脉血流速度、平板运动试验、缓解心绞痛方面与治疗前相比差异有统计学意义(P均<0.01),联合组在冠脉血流速度、平板运动试验、缓解心绞痛与阿司匹林组及氯吡格雷组比较差异有统计学意义(P均<0.01),而阿司匹林组与氯吡格雷组在冠脉血流速度、次级量平板运动试验、缓解心绞痛方面比较差异有统计学意义(P=0.345、0.273、0.467)。结论联合应用阿司匹林与氯吡格雷抗血小板治疗能更好改善冠状动脉患者血流情况,抗血小板是冠状动脉慢血流有效的治疗方法。
Objective To observe the therapeutic effect of aspirin and clopidogrel in the treatment of slow blood flow in coronary arteries and to study and evaluate the therapeutic effect of aspirin and clopidogrel on coronary blood flow. Methods Coronary flow velocity was evaluated by corrected TIMI grading method. 124 patients with chronic coronary artery disease were randomly divided into aspirin group (n = 38), clopidogrel group (n = 42) and combination group (n = 44) The treadmill exercise test and left ventricular ejection fraction (LVEF) were performed. After 1 month of treatment, the coronary blood flow velocity, treadmill exercise test and angina pectoris frequency were evaluated again. Results There were significant differences in coronary blood flow velocity, treadmill exercise test and angina pectoris between the three groups before and after treatment (P all <0.01). There was no significant difference in coronary blood flow velocity, treadmill exercise test, Angina pectoris and aspirin group and clopidogrel group difference was statistically significant (P all <0.01), while the aspirin group and clopidogrel group coronary flow velocity, sub-plate treadmill exercise test, relieve angina Statistical significance (P = 0.345,0.273,0.467). Conclusion The combination of aspirin and clopidogrel antiplatelet therapy can better improve blood flow in patients with coronary artery disease. Antiplatelet is an effective treatment for coronary arterial slow blood flow.