两种剂量氯吡格雷在急性ST段抬高心肌梗死中应用的临床效果对比观察

目的：探讨不同剂量氯吡格雷用于急性ST段抬高心肌梗死的辅助治疗效果。方法：选取2008年6月～2010年6月住院的122例急性ST段抬高心肌梗死患者为研究对象,将其随机分为观察组（61例）和对照组（61例）。观察组患者溶栓治疗开始前口服氯吡格雷600 mg,对照组给予300 mg,之后两组患者每日给予75 mg氯吡格雷维持剂量。结果：观察组和对照组两组患者治疗后的总有效率分别为90.16%（55/61）和73.77%（45/61）,两组比较,差异有统计学意义（P〈0.05）,术后两组患者CK-MB峰值分别为（204.12±80.60）U/L和（315.04±85.12）U/L,达峰时间分别为（9.31±1.78）h和（15.37±4.78）h,观察组CK-MB峰值和达峰时间均小于对照组,两组比较,差异有统计学意义（P〈0.05）。结论：起始剂量为600 mg的高剂量氯吡格雷应用于急性ST段抬高心肌梗死的治疗比低剂量（300 mg）具有更好的疗效和安全性。

The clinical effect observation of two doses of Clopidogrel for treating acute ST-segment elevation myocardial infarction

Objective： To study the clinical effect of two doses of Clopidogrel for treating acute ST-segment elevation myocardial infarction.Methods： 122 patients June 2008 to June 2010 with acute ST segment elevation myocardial infarction were randomly divided into the observation group（61 cases） and control group（61 cases）.The observation group was given Clopidogrel 600 mg and the control group was given Clopidogrel 300 mg before the start of thrombolytic therapy,and then two groups were given Clopidogrel 75 mg as daily maintenance dose.Results： The total effective rate of observation group and control group were 90.16%（55/61） and 73.77%（45/61）,the difference was statistically significant（P0.05）,peak CK-MB of two groups were（204.12±80.60） U/L and（315.04±85.12） U/L respectively,Tmax were（9.31±1.78） h and（15.37±4.78） h respectively,CK-MB peak and peak time of observation group were less than the control group,the difference was statistically significant（P0.05）.Conclusion： The initial high dose of 600 mg of Clopidogrel used in acute ST-segment elevation myocardial infarction has better efficacy and safety than the low dose（300 mg）.