大剂量氯吡格雷对选择性经皮冠状动脉介入术的影响

目的 研究大剂量氯吡格雷用于选择性经皮冠脉介入治疗（PCI）患者的疗效及安全性.方法 确诊冠心病并接受择期PCI的患者173例,分成氯吡格雷强化组（波立维600 mg,87例）和氯吡格雷标准组 （波立维300 mg,86例）.PCI治疗前两组患者分别给予波立维600 mg和波立维300 mg治疗;PCI术后每日分别给予150 mg和75 mg,共 7 d;以后均服用波立维75 mg至1年以上.观察两组患者的疗效及不良反应的发生情况.结果 氯吡格雷强化组和氯吡咯雷标准组达到的完全血运重建率分别为93.8% 和 87.2%（P＜0.05）;两组主要不良心脑血管事件（MACCE）发生率分别为2.0%和6.8%,差异均有统计学意义（P＜0.01）;而出血和血管并发症的发生率差异无统计学意义（1.6%比1.7%,P＞0.05）.结论 氯吡格雷强化组PCI的疗效和安全性均优于氯吡格雷标准组.

Affection for selective percutaneous coronary intervention with high dose clopidogrel

Objective To study therapeutic efficacy and safety of high dose clopidogrel in patients with coronary heart diseases （CHD） who underwent selective percutaneous coronary intervention（PCI）. Methods A to-tal of 173 CHD patients underwent PCI were divided into strong clopidogrel group （received 600 mg of plavix, n=87） and standard clopidogrel group （received 300 mg of plavix, n=86）. Before PCI, the two groups were respec-tively given 600 mg and 300 mg of plavix. They were respectively given 150 and 75 mg every day for 7 days after PCI. Then they were all given 75 mg every day over one year. Therapeutic efficacy and occurrence of adverse reac-tions were observed in the two groups. Results There were significant difference in complete revascularization rate （93.8% vs 87.2%, P〈0.05）, major adverse cardiovascular-cerebral events （MACCE）（2.0% vs 6.8%,P〈0.01）. There were no differences in bleeding and vascular complications （1.6% vs 1.7%, P〉0.05 ） between strong clopi-dogrel group and standard clopidogrel group. Conclusion Strong clopidogrel is more effective and safe than stan-dard clopidogrel in selective PCI of CHD.