氯吡格雷治疗高龄冠心病患者的安全性

目的 观察氯吡格雷治疗高龄老年冠心病患者的安全性。方法 将入选口服氯吡格雷的患者按年龄分为3组：高龄老年组70例，年龄≥80岁，平均84．50±8．16岁；老年组60例，年龄60—79岁，平均76．50±7．16岁；对照组82例，年龄≤59岁，平均56．50±3．16岁。分别口服氯吡格雷75mg／d后6个月、12个月检测肝功、肾功、血小板计数、白细胞计数和中性粒细胞计数及血脂的变化．并观察各组发生胃肠道出血及其他不良反应，比较高龄老年组、老年组和对照组患者口服氯吡格雷的安全性。结果 治疗前后3组患者肝功、肾功、血小板计数、白细胞计数、中性粒细胞计数结果差异无统计学意义（P〉0．05）。3组患者均同时服用他汀类调脂药，总胆固醇和低密度脂蛋白胆固醇治疗后6个月、12个月低于治疗前（P〈0．05），而治疗后6个月与治疗后12个月结果变化无统计学意义（P〉0．05）。3组消化道出血的发生率无统计学意义（P〉0．05）。结论 高龄老年冠心病患者口服氯吡格雷安全性较好。

The safety of the clopidogrel in treating coronary heart disease in elderly patients

Objective To study the safety of the clopidogrel in treating coronary heart disease in elderly patients. Methods 212 coronary heart disease patients were divided into oldest old group,70 patients（range 80-92 years）,mean 84.50± 8.16 with CAD,old group with 60 patients aged 60-79 years old mean 76.50±7.16 and younger group with 82 patients 59 years old mean 56.50±3.16. All the patients treated with 75mg of clopidogrel. The blood lipid,the function of the liver and the kidney, platelet, leukocyte count, neutrophils （N） , the risk of upper gastrointestinal bleeding and other adverse effects were monitored before treatment and after treatment for 6 months and 12 months respectively. Results There was no significant difference in the function of the liver and the kidney,platelet,leukocyte count, N and gastrointestinal hemorrhage between 3 groups before the treatment and after 6 months and 12 months（P〉0.05）. The TC and LDL-C of blood lipid was lower than those before treatment （P〈 0.05）. There was no significant difference between after treatment 6 months group and 12 months group. Conclusions Clopidogrel is effective and safe in treating CAD in elderly patients.