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非ST段抬高型急性冠状动脉综合征患者经皮冠状动脉介入治疗术后强化抗血小板治疗临床效果
引用本文:于凝,惠永明,马超,熊永红,仲崇星. 非ST段抬高型急性冠状动脉综合征患者经皮冠状动脉介入治疗术后强化抗血小板治疗临床效果[J]. 中国介入心脏病学杂志, 2012, 20(4): 199-203
作者姓名:于凝  惠永明  马超  熊永红  仲崇星
作者单位:100071,北京丰台医院心内科CCU病房
摘    要:目的 观察非ST段抬高型急性冠状动脉综合征患者经皮冠状动脉介入治疗(PCI)术后应用不同剂量的氯吡格雷疗效和安全性.方法 共入选急性非ST段抬高型冠状动脉综合征行PCI术的患者506例,计算机简单随机法分为标准组、强化组.标准组入院后给予氯吡格雷300 mg顿服,后予75 mg/d维持;强化组入院后给予300 mg顿服,后予150 mg/d口服至PCI术后5d,后75 mg/d维持.所有患者均于入院、顿服氯吡格雷300 mg后24 h、术前及术后5d行ADP诱导的血小板聚集率(PA)检查.于入院及术后5d行血常规检查,观察血小板变化,并随访术后30 d主要心血管事件和出血事件的发生情况.结果 强化组术前及术后5d的PA明显下降,强化组术前及术后5d的PA(%)较标准组明显减低,差异具有统计学意义(t=18.3929,P<0.05;t=13.1384,P<0.005).强化组与标准组比较30 d主要心血管事件有减低趋势,但未见有统计学意义.两组TIMI出血事件未见有明显差异.结论 强化抗血小板治疗可以明显抑制血小板聚集率,同时出血风险未见明显增加,是安全可行的.

关 键 词:氯吡格雷  血管成形术,经腔,经皮冠状动脉  血小板聚集  急性冠状动脉综合征

The clinical effect study of intensive antiplatelet therapy in patients of acute non ST-segment elevation coronary syndrome after PCI
YU Ning , HUI Yong-ming , MA Chao , XIONG Yong-hong , ZHONG Chong-xing. The clinical effect study of intensive antiplatelet therapy in patients of acute non ST-segment elevation coronary syndrome after PCI[J]. Chinese Journal of Interventional Cardiology, 2012, 20(4): 199-203
Authors:YU Ning    HUI Yong-ming    MA Chao    XIONG Yong-hong    ZHONG Chong-xing
Affiliation:.Bejing Fengtai Hospital,Bejing 100071,China
Abstract:Objective To observe efficacy and safety of different clopidogrel dosage treatment programs on acute non ST-segment elevation coronary syndrome patients after PCI.Methods 506 cases of non ST-segment elevation myocardial infarction patients,who all underwent PCI were included.Patients were randomly divided into the standard group and the intensive treatment group.Patients of standard group received clopidogrel 300 mg after admission then 75 mg/d maintainance.Patients of intensive treatment group received clopidogrel 300 mg after admission then,150 mg/d till 5 days after PCI and 75 mg/d for maintainance.All of the patients had platelet aggregation rate(PA) examination in hospital at admission,24 h after clopidogrel treatment,at the preoperation and 5 days after PCI.All patients do PLT examination at the preoperative and 5 days after PCI.Follow-up of major cardiovascular events and bleeding events were recorded for 30 days.Results The PA of the intensive treatment group were decreased in the preoperation and 5 days after PCI.Compared with the standard group,the PA of the intensive treatment group were decreased in preoperation and 5 days after PCI(t=18.3929,P<0.05;t=13.1384,P<0.005).During 30 days follow-up,major cardiovascular events of the intensive treatment group were none compared with 4 cases in the standard group.The bleeding events incidence of the two group had no significant difference.Conclusions The intensive antiplatelet therapy can inhibit platelet aggregation rate without increasing the risk of bleeding.
Keywords:Clopidogrel  Angioplasty,transluminial,percutaneous coronary  Platelet aggregation  Acute coronary syndrome
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