CAJ | 학술논문

目的评价氯吡格雷联合阿司匹林、尿激酶溶栓治疗急性ST段抬高型心肌梗死(STEMI)的有效性和安全性.方法选取STEMI患者96例,按是否加用氯吡格雷分为两组:对照组48例,采用肠溶阿司匹林片口服,尿激酶静脉溶栓治疗,溶栓12 h后皮下注射低分子肝素;氯吡格雷组48例,在对照组治疗基础上加用氯吡格雷负荷量300 mg,以后75 mg/d.临床观察指标为梗死相关动脉心肌梗死溶栓试验(TIMI)Ⅲ级血流、冠脉内血栓、出血并发症、住院期间心血管事件.结果氯吡格雷组患者梗死相关动脉TIMIⅢ级血流者的比例较对照组显著升高(P＜0.05),冠脉内血栓发生率较对照组显著降低(P＜0.05).两组患者在出血并发症、再梗死、心源性死亡、总死亡方面差异无统计学意义(P＞0.05).结论氯吡格雷联合阿司匹林、尿激酶溶栓治疗STEMI能改善梗死血管畅通率,并不增加出血并发症.
목적 평개록필격뢰연합아사필림、뇨격매용전치료급성ST단태고형심기경사(STEMI)적유효성화안전성.방법 선취STEMI환자96례,안시부가용록필격뢰분위량조:대조조48례,채용장용아사필림편구복,뇨격매정맥용전치료,용전12 h후피하주사저분자간소;록필격뢰조48례,재대조조치료기출상가용록필격뢰부하량300 mg,이후75 mg/d.림상관찰지표위경사상관동맥심기경사용전시험(TIMI)Ⅲ급혈류、관맥내혈전、출혈병발증、주원기간심혈관사건.결과 록필격뢰조환자경사상관동맥TIMIⅢ급혈류자적비례교대조조현저승고(P＜0.05),관맥내혈전발생솔교대조조현저강저(P＜0.05).량조환자재출혈병발증、재경사、심원성사망、총사망방면차이무통계학의의(P＞0.05).결론 록필격뢰연합아사필림、뇨격매용전치료STEMI능개선경사혈관창통솔,병불증가출혈병발증.
Objective To investigate the effectiveness and safety of clopidogrel,Asprin,and urokinase thrombolysis on the treatment of acute myocardial infarction with ST-segement elevation (STEMI).Methods Niney-six STEMI patients were randomizedly divided into two groups according to whether or not clopidogrel(75 mg,once daily) was added.We investigated TIMI myocardial-perfusion grade of 3,intracoronary thrombus,hemorrhagic complications,and cardiac events during hospitalization.Results As compared with placebo,more optimal myocardial reperfusion (defined by a TIMI myocardial-perfusion grade of 3)in clopidogrel group(P＜0.05).Intracoronary thrombus was significantly reduced in clopidogrel group compared with the control group(P＜0.05).There was no significant difference in the incidence of hemorrhagic complications associated ,reinfarction,cardiac death,and total death in both groups(P＞0.05).Conclusion In patients who have myocardial infarction with ST-segment elevation and who receive aspirin and urokinase thrombolysis,the addition of clopidogrel improves the patency rate of the infarct-related artery and does not increase hemorrhageic complications.