CAJ | 학술논문

目的：探讨氯吡格雷联合阿司匹林治疗老年 ST 段抬高型急性心肌梗死的疗效及安全性。方法将180例行溶栓治疗的老年 ST 段抬高型急性心肌梗死患者随机分入对照组与观察组，每组各90例。给予对照组患者口服阿司匹林治疗，观察组患者接受氯吡格雷联合阿司匹林治疗，连用4周。比较两组死亡、再发心肌梗死、梗死后心绞痛的联合终点事件发生率、患者 ST-T 的改变以及出血并发症发生率。结果观察组联合终点事件发生率为5．6％，显著低于对照组23．3％（P ＜0．05）；观察组与对照组心电图判定 ST-T 治疗有效率分别为95．6％和75．5％，差异有统计学意义（P ＜0．05）；观察组与对照组出血并发症发生率差异无统计学意义（10．0％比6．7％，P ＜0．05）。结论氯吡格雷联合阿司匹林治疗老年 ST 段抬高型急性心肌梗死可显著降低心血管事件发生率，且不增加出血并发症。
목적：탐토록필격뢰연합아사필림치료노년 ST 단태고형급성심기경사적료효급안전성。방법장180례행용전치료적노년 ST 단태고형급성심기경사환자수궤분입대조조여관찰조，매조각90례。급여대조조환자구복아사필림치료，관찰조환자접수록필격뢰연합아사필림치료，련용4주。비교량조사망、재발심기경사、경사후심교통적연합종점사건발생솔、환자 ST-T 적개변이급출혈병발증발생솔。결과관찰조연합종점사건발생솔위5．6％，현저저우대조조23．3％（P ＜0．05）；관찰조여대조조심전도판정 ST-T 치료유효솔분별위95．6％화75．5％，차이유통계학의의（P ＜0．05）；관찰조여대조조출혈병발증발생솔차이무통계학의의（10．0％비6．7％，P ＜0．05）。결론록필격뢰연합아사필림치료노년 ST 단태고형급성심기경사가현저강저심혈관사건발생솔，차불증가출혈병발증。
Objective To explore the effect and safety of clopidogrel and aspirin combination in the treat-ment of ST-segment elevation acute myocardial infarction in the aged patients.Methods A total 180 aged patients with ST-segment elevation acute myocardial who underwent thrombolytic therapy were randomly divided into control group and treatment group,with 90 patients in each group.Patients in control group were treated with aspirin and treat-ment group received the combination of clopidogrel and aspirin treatment for 4 weeks.The combined endpoint events of death,recurrent myocardial infarction and postinfarction angina,the change of ST-T and bleeding complications were re-corded and analyzed.Results The combined endpoint events in treatment group was 5.6%,which was much lower than that in control group (23.3%,P <0.05);The effective rates in the treatment of ST-T judged by ECG were 95.6% and 75.5% in treatment group and control group with significant difference (P <0.05);There were no significant differ-ence in bleeding complications between the two groups (10.0% vs 6.7%,P <0.05).Conclusions The combination of Clopidogrel and aspirin in the treatment of ST-segment elevation acute myocardial infarction in the aged patients could greatly decrease the incidence of cardiovascular events with no increase in the risk of bleeding complication.