阿替普酶静脉溶栓联合氯吡格雷、阿司匹林治疗急性心肌梗死疗效观察60例

目的探讨阿替普酶静脉溶栓联合氯吡格雷、阿司匹林治疗急性心肌梗死临床疗效,及其可能作用原理分析。方法从该院2010年9月—2013年4月收治的急性心肌梗死患者中选取120例,其中60例给予阿替普静脉溶栓治疗,标记为对照组;60例给阿替普酶溶栓＋氯吡格雷、阿司匹林联合治疗,标记为实验组,观察两组冠脉再通率及其并发症发生率。结果两组治疗效果实验组总有效率（93%）,对照组总有效率（72%）,差异有统计学意义（P〈0.05）;两组并发症情况实验组：3例出血。出血死亡1例,总数4例;对照组：出血13例,出血死亡3例,总数16例,两组差异有统计学意义（P〈0.05）。结论阿替普酶溶栓联合抗凝药治疗急性心肌梗死效果明显优于单独应用溶栓治疗,且并发症发生率明显下降,值得临床大力推广。

Clinical Observation of the Efficacy of Intravenous Thrombolysis with Alteplase and Clopidogrel,Aspirin in the Treatment of 60 Cases of Acute Myocardial Infarction

Objective To observe the efficacy of intravenous thrombolysis with alteplase and clopidogrel, aspirin in the treatment of acute myocardial infarction, and analyze its possible principle of action. Methods 120 cases of patients were selected from the pa- tients with acute myocardial infarction admitted to our hospital from September, 2010 to April, 2013. Of whom, 60 patients were given the treatment of intravenous thrombolysis with aheplase, marked as the control group; and the other 60 patients were given the treatment of aheplase thrombolysis plus elopidogrel and aspirin therapy, marked as the experimental group. The coronary re- canalization rate and the incidence of complications of the two groups were observed. Results The treatment effect of the two groups： The experimental group＇s total efficiency was 93%, higher than the control group＇s 72%, the difference was statistically sig- nificant（P〈0.05）. Two sets of complications situation： The experimental group： 3 cases of bleeding, bleeding to death 1 case, the to- tal number was 4 cases; The control group： 13 cases of bleeding, bleeding to death 3 cases, a total of 16 cases, the difference was statistically significant （P〈0.05）. Conclusion Alteplase thrombolysis combined with anticoagulant in the treatment of acute myocar- dial infarction has better effect than thrombolytic therapy alone does, and the incidence of complications significantly decreased, which is worthy of clinical vigorously promotion.