负荷量氯吡格雷、阿司匹林片治疗非ST段抬高急性冠脉综合征临床观察

目的研究负荷量氯吡格雷联合阿司匹林片治疗非ST段抬高急性冠脉综合征（ACS）的临床疗效及安全性。方法选择非ST段抬高性ACS（不稳定心绞痛/非ST抬高心肌梗死）病例170例,随机分为常规治疗组（85例）和强化治疗组（85例）。常规使用抗心绞痛药物的基础上（硝酸酯类、β-受体阻滞剂、钙拮抗剂、低分子肝素5 000 U、降脂药）,常规治疗组仅加服阿司匹林;强化治疗组联合使用负荷量氯吡格雷和负荷量阿司匹林。总疗程3个月。结果强化治疗组的疗效显著优于常规治疗组（P〈0.05）,心绞痛、心肌梗死（含复发）、心力衰竭的发生率也显著低于常规治疗组（P〈0.05）,两组死亡率差异无统计学意义（P〉0.05）,两组不良反应均较小。结论负荷量氯吡格雷联合阿司匹林片治疗非ST段抬高性ACS患者可有效降低心血管事件发生率,安全性好。

Clinical observation of therapy of loading dose Clopidogrel and Aspirin to non-ST elevation acute coronary syndrome

Objective To study the clinical efficacy and safety of treatment of non-ST segment elevation acute coronary syndrome(ACS) with loading dose of Clopidogrel and Aspirin.Methods 170 cases of non-ST segment elevation ACS(Unstable angina/non-ST-elevation myocardial infarction) were randomly divided into the routine treatment group and the intensive treatment group.Based on routine use of anti-angina drugs(Nitrates,β-blockers,Calcium antagonists,low molecular weight Heparin 5 000 U,lipid-lowering drugs),and the patients of the routine treatment group was just treated with Aspirin,the patients of the intensive therapy group were treated with loading dose of Clopidogrel and loading dose of Aspirin;total treatment course were 3 months.Results Efficacy of intensive treatment group was significantly better than the routine therapy group(P<0.05),the incidences of angina,myocardial infarction(including recurrence) and heart failure were significantly lower in the intensive treatment group than that of the routine treatment group(P<0.05);there was no significant difference of mortality in the two groups(P>0.05).The side effects of two groups were slight.Conclusion The incidence of cardiovascular events of non-ST segment elevation ACS can be effectively reduced after joint treated with loading dose of Clopidogrel and Aspirin.And it is safety too.