不同剂量氯吡格雷对急性心肌梗死患者急诊介入术后血小板聚集率和hs-CRP水平的影响

目的：探讨不同剂量氯吡格雷对急性心肌梗死患者急诊介入术后血小板聚集率和超敏c反应蛋白（hs—CRP）水平的影响。方法：80例急性ST段抬高心肌梗死（STEMI）患者随机分为两组，两组均于PCI术前均给予氯吡格雷300mg负荷剂量＋阿司匹林肠溶片300mg口服，高剂量组予术后氯吡格雷150mg／d维持（7d后改75mg／d维持），标准剂量组予75mg／d维持，比较两组手术前后血小板聚集率、血清hs-cRP水平及临床终点事件。结果：两组术后血小板聚集率及血清hs—CRP水平比较均有明显下降，但上述指标在高剂量组均明显低于标准剂量组，差异有统计学意义（P〈0．05）；两组联合终点事件及出血事件发生率比较，差异无统计学意义（P〉0．05）。结论：sTEMI患者PCI术后采用高氯吡格雷维持剂量较标准维持量可进一步降低患者血小板聚集率及减轻患者的炎症反应。

Effects of different doses clopidogrel on platelet aggregation and hs-ORP levels in patients with acute myocardial infarction after PCI treatment

Objective： To investigate the effects of different doses of clopidogrel on platelet aggre- gation and hs-CRP levels in patients with acute myocardial infarction after PCI. Methods. A total of 80 pa- tients with acute ST -segment elevation myocardial infarction （STEMI） were randomly divided into two groups, both groups were given clopidogrel 300 mg q- aspirin 300 mg before undergoing PCI, and the high-dose group were given clopidogrel 150 mg/d （and 75 mg/d 7 days later）, the standard-dose group were given 75 mg/d after undergoing PCI. End-point events, the platelet aggregation, serum hs-CRP lev- els and clinical endpoints were compared between the two groups. Results： The platelet aggregation and serum hs-CRP levels were significantly decreased after undergoing PCI, but these indicators in the high- dose group were significantly lower than that of the standard -dose group （P〈0.05）. There were no sig- nificant difference in incidence of combined endpoint events and bleeding events between the two groups （P 〈0.05）. Conclusion. Patients with STEMI after undergoing PCI maintained with high maintenance doseof clopidogrel can reduce platelet aggregation and reduce the inflammatory response comparing with stand- ard dose treatment.