现代医院
現代醫院
현대의원
MODERN HOSPITAL
2009年
7期
24-27
,共4页
氯吡格雷%急性冠脉综合征%经皮冠状动脉介入治疗%血小板聚集率%不良事件
氯吡格雷%急性冠脈綜閤徵%經皮冠狀動脈介入治療%血小闆聚集率%不良事件
록필격뢰%급성관맥종합정%경피관상동맥개입치료%혈소판취집솔%불량사건
Clopidogrel%Acute coronary syndromes(ACS)%Percutaneous coronary intervention(PCI)%Platelet aggregation rate%Adverse event
目的 比较不同负荷剂量氯吡格雷在经皮冠脉介入治疗(PCI)术前应用对治疗急性冠脉综合征(ACS)的有效性和安全性,对更高负荷剂量的氯吡格雷安全性进行评估.方法 120例诊断为ACS 的患者随机分为A、B、C三组(na=nb=nc=40),三组患者临床基本资料差异无统计学意义(p>0.05).A、B、C三组分别于术前6 h给予600 mg、450 mg和300 mg负荷剂量氯吡格雷,观察服药前﹑服药后2 h、4 h、6 h血小板聚集率,30天主要终点事件(住院期间休克、死亡、靶血管重建、再发心梗、心绞痛、脑卒中)及术后30天出血事件和不良反应发生情况.结果 与标准的300 mg方案相比,氯吡格雷600 mg比氯吡格雷450 mg前6 h内对血小板激活的抑制程度更大.氯吡格雷负荷剂量的增加可减少30天主要心血管事件的发生率.三组30天出血事件和不良事件发生情况差异无统计学意义(p>0.05).结论 与300 mg氯吡格雷负荷剂量相比,较高的氯吡格雷负荷剂量能够产生更快、更强的血小板抑制,且安全性相似.
目的 比較不同負荷劑量氯吡格雷在經皮冠脈介入治療(PCI)術前應用對治療急性冠脈綜閤徵(ACS)的有效性和安全性,對更高負荷劑量的氯吡格雷安全性進行評估.方法 120例診斷為ACS 的患者隨機分為A、B、C三組(na=nb=nc=40),三組患者臨床基本資料差異無統計學意義(p>0.05).A、B、C三組分彆于術前6 h給予600 mg、450 mg和300 mg負荷劑量氯吡格雷,觀察服藥前﹑服藥後2 h、4 h、6 h血小闆聚集率,30天主要終點事件(住院期間休剋、死亡、靶血管重建、再髮心梗、心絞痛、腦卒中)及術後30天齣血事件和不良反應髮生情況.結果 與標準的300 mg方案相比,氯吡格雷600 mg比氯吡格雷450 mg前6 h內對血小闆激活的抑製程度更大.氯吡格雷負荷劑量的增加可減少30天主要心血管事件的髮生率.三組30天齣血事件和不良事件髮生情況差異無統計學意義(p>0.05).結論 與300 mg氯吡格雷負荷劑量相比,較高的氯吡格雷負荷劑量能夠產生更快、更彊的血小闆抑製,且安全性相似.
목적 비교불동부하제량록필격뢰재경피관맥개입치료(PCI)술전응용대치료급성관맥종합정(ACS)적유효성화안전성,대경고부하제량적록필격뢰안전성진행평고.방법 120례진단위ACS 적환자수궤분위A、B、C삼조(na=nb=nc=40),삼조환자림상기본자료차이무통계학의의(p>0.05).A、B、C삼조분별우술전6 h급여600 mg、450 mg화300 mg부하제량록필격뢰,관찰복약전﹑복약후2 h、4 h、6 h혈소판취집솔,30천주요종점사건(주원기간휴극、사망、파혈관중건、재발심경、심교통、뇌졸중)급술후30천출혈사건화불량반응발생정황.결과 여표준적300 mg방안상비,록필격뢰600 mg비록필격뢰450 mg전6 h내대혈소판격활적억제정도경대.록필격뢰부하제량적증가가감소30천주요심혈관사건적발생솔.삼조30천출혈사건화불량사건발생정황차이무통계학의의(p>0.05).결론 여300 mg록필격뢰부하제량상비,교고적록필격뢰부하제량능구산생경쾌、경강적혈소판억제,차안전성상사.
Objective To compare the efficiency and safety of clopidogrel of different loading-dose in acute coronary syndromes(ACS) patients with percutaneous coronary intervention(PCI) therapy, and, give an assessment of security about higher loading dose of clopidogrel. Methods 120 patients from January 2008 to January 2009 in our hospital were included.They were randomly divided into 3 groups(na=nb=nc=40)and were given 600 mg,450 mg and 300 mg clopidogrel on the 6 hour before PCI. There was no significant difference between the three groups' basic clinical information(p>0.05),such as age, sex and so on. Four points were selected to observe: the platelet aggregation induced by ADP with 5umol/L before and two hours、four hours, six hours after taking medicine; Primary endpoint events, which include shock during hospitalization, death, target revascularization, myocardial infarction, recurrent angina, stroke in 30 days,and Postoperative Bleeding events and adverse Reactions after Surgery in 30 days. Results compared to the standard dose of 300 mg clopidogrel, 600 mg doses clopidogrel can give a greater degree of inhibition on platelet activating than 450 mg doses in the pre-6 h after administration. Increase Clopidogrel loading dose can reduce the occurrence of major cardiovascular events rate. Bleeding events and the occurrence of adverse events was no significant difference among three groups. Conclusions compared to the standard dose of 300 mg clopidogrel, a higher loading dose of clopidogrel can produce much more faster, greater platelet inhibition, and similar security.
