尿激酶联合氯吡格雷阿司匹林治疗急性ST段抬高型心肌梗塞疗效

目的：观察尿激酶溶栓联合氯吡格雷、阿司匹林治疗急性ST段抬高型心肌梗塞（STEMI）的临床疗效及安全性。方法：87例STEMI符合溶栓治疗患者，被随机分为两组，常规治疗组（40例）和氯吡格雷组（47例），两组溶栓前均给予阿司匹林0．3g口服，氯吡格雷组于入院后即刻口服氯吡格雷300mg，次日改为75mg，1次／d，口服。观察两组治疗的血管再通率，30d内的主要心血管不良事件（死亡、AMI、恶性心律失常、肺水肿等）的发生率。结果：较之对照组，氯吡格雷组梗塞相关血管再通率明显提高（60．3％：74．5％，P〈0．05），梗塞后心绞痛发生率、30d死亡及再发心肌梗塞率、严重心律失常发生率、肺水肿发生率均显著下降（P〈0．05）。结论：尿激酶溶栓联合氯吡格雷、阿司匹林治疗急性ST段抬高型心肌梗塞是安全有效的。

Efficiency of urokinase combined clopidogrel and aspirin in the patients with ST-segment elevation myocardial infarction

Objective： To observe the effects and safety of urokinase combined clopidogrel and aspirin in the patients with ST segment elevation myocardial infarction （STEAMI）. Methods： A total of 87 cases with STEMI were randomly divided into routine therapy group （control group, 40 cases） and clopidogrel group （47 cases）, who were treated with clopidogrel 300mg as soon as the STEMI patients admitted before intravenous thrombolytic therapy. The patients of two groups all accepted aspirin 300 mg. The patency rate of coronary artery and the incidence of adverse cardiac events （death, myocardial infarction, malignant ventricular arrhythmia, pulmonary edema） were recorded up to 30 days. Results ： The patency rate of occlusive infarction related coronary artery in clopidogrel group was significantly higher than that of control group （74.5% ： 60.3%, P〈0.05）. The incidence rates of past-infarction angina and adverse cardiac events in clopidogrel group were significantly lower than those of control （P〈0.05 all）. The hemorrhage incidence were similar between two groups. Conclusion： Urokinase combined clopidogrel and aspirin could be effective and safe in patients with ST--segment elevation myocardial infarction.