氯吡格雷联合阿司匹林和尿激酶治疗急性ST段抬高型心肌梗死的临床疗效研究

目的 评价氯吡格雷联合阿司匹林、尿激酶溶栓治疗急性ST段抬高型心肌梗死(STEMI)的有效性和安全性.方法 选取STEMI患者96例,按是否加用氯吡格雷分为两组:对照组48例,采用肠溶阿司匹林片口服,尿激酶静脉溶栓治疗,溶栓12 h后皮下注射低分子肝素;氯吡格雷组48例,在对照组治疗基础上加用氯吡格雷负荷量300 mg,以后75 mg/d.临床观察指标为梗死相关动脉心肌梗死溶栓试验(TIMI)Ⅲ级血流、冠脉内血栓、出血并发症、住院期间心血管事件.结果 氯吡格雷组患者梗死相关动脉TIMIⅢ级血流者的比例较对照组显著升高(P＜0.05),冠脉内血栓发生率较对照组显著降低(P＜0.05).两组患者在出血并发症、再梗死、心源性死亡、总死亡方面差异无统计学意义(P＞0.05).结论 氯吡格雷联合阿司匹林、尿激酶溶栓治疗STEMI能改善梗死血管畅通率,并不增加出血并发症.

Clinical Study of Clopidogrel,Sprin and Urokinase Thrombolysis on the Treatment of Acute Myocardial Infarction with ST-segement Elevation

Objective To investigate the effectiveness and safety of clopidogrel,Asprin,and urokinase thrombolysis on the treatment of acute myocardial infarction with ST-segement elevation (STEMI).Methods Niney-six STEMI patients were randomizedly divided into two groups according to whether or not clopidogrel(75 mg,once daily) was added.We investigated TIMI myocardial-perfusion grade of 3,intracoronary thrombus,hemorrhagic complications,and cardiac events during hospitalization.Results As compared with placebo,more o...