大负荷剂量氯吡格雷治疗非ST段抬高型心肌梗死疗效观察

目的 探讨大负荷剂量氯吡格雷在非ST段抬高型心肌梗死中的治疗效果。方法 非ST段抬高型心肌梗死患者81例随机分为观察组41例和对照组40例,在常规治疗基础上,观察组第1天给予大负荷剂量氯吡格雷600mg,对照组给予小负荷剂量氯吡格雷300mg,以后2组均给予75mg/d维持量,疗程均为4周,观察2组治疗效果。结果 观察组治疗后胸痛发作次数（2.3±1.0）次/d、发作持续时间（4.2±1.1）min与对照组（（3.5±1.1）次/d,（7.6±1.5）min）比较差异有统计学意义（P〈0.01）;观察组治疗总有效率（90.2%）高于对照组（70.0%）（P〈0.05）;2组治疗后总胆固醇、低密度脂蛋白胆固醇均较治疗前下降（P〈0.05）,但2组间比较差异无统计学意义（P〉0.05）,2组治疗前、后三酰甘油比较差异无统计学意义（P〉0.05）;观察组不良反应发生率（21.95%）与对照组（20.00%）比较差异无统计学意义（P〉0.05）。结论 大负荷剂量氯吡格雷治疗非ST段抬高型心肌梗死疗效确切。

Therapeutic effect of high-dose clopidogrel on non-ST elevated myocardial infarction

Objective To discuss the therapeutic effect of high-dose clopidogrel on non-ST elevated myocardial infarction. Methods Eighty-one patients with non-ST elevated myocardial infarction were randomy divided into observation group （n=41） and control group （n=40）. Based on the routine treatment, observation group received high- dose clopidogrel （600 mg）, while control group was given low-dose clopidogrel （300 mg） on the first day, followed by 75 mg/d, totally for 4 weeks. The therapeutic effect was observed in both two groups. Results The frequency and the duration of chest pain were （2.3±1.0） times per day and （4.2± 1. 1） rain in observation group, significantly different from those in control group （（3.5±1.1） times per day, （7.6±1.5） min） （P〈0.01）. The effective rate was 90.2% in observation group, higher than that in control group （70.0%） （P〈0.05）. The levels of total cholesterol and low density lipoprotein-cholesterol were significantly lower after treatment in both two groups （P〈 0.05）, but there were no significant differences between two groups （P〉0.05）. The level of triacylglycerol did not change significantly after treatment in both groups （P〉0.05）. There was no significant difference in the incidence of adverse reaction between observation group （21.95%） and control group （20.00%） （P〉0.05）. Conclusion High-dose clopidogrel is effective for non-ST elevated myocardial infarction.