氯吡格雷与阿司匹林联合治疗非ST段抬高型心肌梗死临床观察(1)
[摘要] 目的 观察氯吡格雷与阿司匹林联合治疗非ST段抬高型心肌梗死的临床疗效。 方法 选择本科非ST段抬高型心肌梗死患者96例，随机分为治疗组50例与对照组46例，在常规治疗的基础上，治疗组给予氯吡格雷每日75 mg(首剂300 mg)，阿司匹林每日100 mg，对照组仅给予阿司匹林100 mg，观察4周，观察两组患者的临床疗效与不良反应。 结果 治疗4周后，治疗组总有效率为88%，对照组为63%，两组比较差异有统计学意义(P < 0.05)。 结论 氯吡格雷与阿司匹林联合治疗非ST段抬高型急性心肌梗死可有效降低心血管事件、缺血性脑卒中，临床疗效好，值得借鉴。
[关键词] 氯吡格雷；阿司匹林；非ST段抬高型心肌梗死；临床观察
[中图分类号] R972 [文献标识码] A [文章编号] 1674-4721(2012)06(a)-0065-02
Clinical observation of clopidogrel and aspirin in the treatment of non ST segment elevation myocardial infarction
LI Mingyu
The People''s Hospital of Tumen City in Jilin Province, Tumen 133100, China
[Abstract] Objective To observe the clinical curative effect of clopidogrel combined with aspirin in the treatment of non ST segment elevation myocardial infarction. Methods Ninty six patients were randomly divided into the treatment group 50 cases and control group of 46 cases, based on the routine treatment, the treatment group were treated with clopidogrel 75 mg daily (the first dose of 300 mg), aspirin 100 mg daily, the control group was only given aspirin 100 mg, observed for 4 weeks, the clinical efficacy and adverse reaction of two groups patients were observed. Results After 4 weeks treatment, the total effective rate of the treatment group was 85.7%, the control group was 63.3%, the two groups had significant difference (P < 0.05). Conclusion The clopidogrel and aspirin in the treatment of non ST segment elevation acute myocardial infarction is effective in reducing cardiovascular events, has good curative effect, less adverse reaction, it is worthy of popularization and application.
[Key words] Clopidogrel; Aspirin; Non ST segment elevation myocardial infarction; Clinical observation
冠状动脉粥样硬化性心脏病指由于冠状动脉粥样硬化管腔狭窄、痉挛或阻塞导致心肌缺血、缺氧或坏死而引起的心脏病，它是动脉粥样硬化导致器官病变的最常见类型[1]。急性心肌梗死由于冠状动脉急性狭窄或闭塞，供血持续减少或终止，所产生的心肌严重缺血和坏死。分为ST段抬高型心肌梗死和非ST段抬高型心肌梗死，治疗上在严格掌握适应证的情况下及早进行溶栓、介入治疗与外科手术治疗基础上，积极抗凝、抗血小板治疗尤为重要，并能明显降低患者心血管事件、脑梗死、再发心肌梗死，提高远期疗效、生活质量。本文旨在观察氯吡格雷与阿司匹林联合治疗非ST段抬高型急性心肌梗死的临床疗效。
1 资料与方法
1.1 一般资料
选择本院心内科2010年6月～2011年4月住院诊治的非ST段抬高性心肌梗死患者96例，具有典型的胸痛，时间大于30 min，血清肌酸激酶(CK)增高；心肌坏死标志物升高；心电图表现ST段明显压低0.4～0.6 mV，T波倒置。入选前均未服用氯吡格雷，将96例患者随机分为治疗组50例，其中，男35例，女15例，平均年龄(60±8)岁，吸烟3例、高血压4例、糖尿病3例、血脂异常2例；对照组46例，男28例，女18例，平均年龄(65±7)岁，吸烟者4例、高血压3例、糖尿病3例、血脂异常2例；两组患者在吸烟、性别、高血压、糖尿病、血脂异常、心功能等方面差异无统计学意义(P > 0.05)，具有可比性。
1.2 方法
两组患者均接受常规治疗，包括阿司匹林片、硝酸酯类、血管紧张素转换酶抑制剂、β受体阻断剂、他汀类以及注射低分子肝素5 000 U，每12小时1次，连用7 d。治疗组在此基础上给予氯吡格雷每日75 mg(首剂300 mg)，对照组仅给予阿司匹林100 mg，观察比较两组在治疗期间内心脑血管事件(包括心绞痛复发、ST段抬高型急性心肌梗死、心源性猝死、缺血性脑卒中)的情况，以及药物不良反应。, http://www.100md.com(李明玉)
[关键词] 氯吡格雷；阿司匹林；非ST段抬高型心肌梗死；临床观察
[中图分类号] R972 [文献标识码] A [文章编号] 1674-4721(2012)06(a)-0065-02
Clinical observation of clopidogrel and aspirin in the treatment of non ST segment elevation myocardial infarction
LI Mingyu
The People''s Hospital of Tumen City in Jilin Province, Tumen 133100, China
[Abstract] Objective To observe the clinical curative effect of clopidogrel combined with aspirin in the treatment of non ST segment elevation myocardial infarction. Methods Ninty six patients were randomly divided into the treatment group 50 cases and control group of 46 cases, based on the routine treatment, the treatment group were treated with clopidogrel 75 mg daily (the first dose of 300 mg), aspirin 100 mg daily, the control group was only given aspirin 100 mg, observed for 4 weeks, the clinical efficacy and adverse reaction of two groups patients were observed. Results After 4 weeks treatment, the total effective rate of the treatment group was 85.7%, the control group was 63.3%, the two groups had significant difference (P < 0.05). Conclusion The clopidogrel and aspirin in the treatment of non ST segment elevation acute myocardial infarction is effective in reducing cardiovascular events, has good curative effect, less adverse reaction, it is worthy of popularization and application.
[Key words] Clopidogrel; Aspirin; Non ST segment elevation myocardial infarction; Clinical observation
冠状动脉粥样硬化性心脏病指由于冠状动脉粥样硬化管腔狭窄、痉挛或阻塞导致心肌缺血、缺氧或坏死而引起的心脏病，它是动脉粥样硬化导致器官病变的最常见类型[1]。急性心肌梗死由于冠状动脉急性狭窄或闭塞，供血持续减少或终止，所产生的心肌严重缺血和坏死。分为ST段抬高型心肌梗死和非ST段抬高型心肌梗死，治疗上在严格掌握适应证的情况下及早进行溶栓、介入治疗与外科手术治疗基础上，积极抗凝、抗血小板治疗尤为重要，并能明显降低患者心血管事件、脑梗死、再发心肌梗死，提高远期疗效、生活质量。本文旨在观察氯吡格雷与阿司匹林联合治疗非ST段抬高型急性心肌梗死的临床疗效。
1 资料与方法
1.1 一般资料
选择本院心内科2010年6月～2011年4月住院诊治的非ST段抬高性心肌梗死患者96例，具有典型的胸痛，时间大于30 min，血清肌酸激酶(CK)增高；心肌坏死标志物升高；心电图表现ST段明显压低0.4～0.6 mV，T波倒置。入选前均未服用氯吡格雷，将96例患者随机分为治疗组50例，其中，男35例，女15例，平均年龄(60±8)岁，吸烟3例、高血压4例、糖尿病3例、血脂异常2例；对照组46例，男28例，女18例，平均年龄(65±7)岁，吸烟者4例、高血压3例、糖尿病3例、血脂异常2例；两组患者在吸烟、性别、高血压、糖尿病、血脂异常、心功能等方面差异无统计学意义(P > 0.05)，具有可比性。
1.2 方法
两组患者均接受常规治疗，包括阿司匹林片、硝酸酯类、血管紧张素转换酶抑制剂、β受体阻断剂、他汀类以及注射低分子肝素5 000 U，每12小时1次，连用7 d。治疗组在此基础上给予氯吡格雷每日75 mg(首剂300 mg)，对照组仅给予阿司匹林100 mg，观察比较两组在治疗期间内心脑血管事件(包括心绞痛复发、ST段抬高型急性心肌梗死、心源性猝死、缺血性脑卒中)的情况，以及药物不良反应。, http://www.100md.com(李明玉)