CAJ | 학술논문

目的：观察高负荷量的氯吡格雷对拟行经皮冠状动脉介入术（ PCI ）治疗的患者的近期疗效和安全性。方法将144例接受冠状动脉介入术治疗的患者根据随机数字表法分为观察组和对照组。观察组于术前给予高负荷量氯吡格雷（600 mg）顿服，对照组给予常规300 mg顿服。分别检测两组服药前和服药后血小板最大凝集率（ MPAR），比较两组术后30 d内的主要临床心血管事件和出血事件的发生情况。结果观察组患者服药后2 h血小板最大聚集率即发生明显下降（ P﹤0.05）；服药4 h后，两组患者最大血小板聚集率均出现显著下降，与治疗前比较差异均有统计学意义（P均﹤0.05）。高剂量氯吡格雷治疗组患者缺血事件、再梗死和血栓形成等并发症的发生率显著低于对照组（ P﹤0.05）。结论 PCI患者术前服用高负荷剂量氯吡格雷较常规负荷剂量预治疗能更大程度抑制直接治疗后的早期血小板凝集情况。可显著改善临床预后，降低不良心血管事件的发生率，且并不增加出血风险，治疗安全有效。
목적：관찰고부하량적록필격뢰대의행경피관상동맥개입술（ PCI ）치료적환자적근기료효화안전성。방법장144례접수관상동맥개입술치료적환자근거수궤수자표법분위관찰조화대조조。관찰조우술전급여고부하량록필격뢰（600 mg）돈복，대조조급여상규300 mg돈복。분별검측량조복약전화복약후혈소판최대응집솔（ MPAR），비교량조술후30 d내적주요림상심혈관사건화출혈사건적발생정황。결과관찰조환자복약후2 h혈소판최대취집솔즉발생명현하강（ P﹤0.05）；복약4 h후，량조환자최대혈소판취집솔균출현현저하강，여치료전비교차이균유통계학의의（P균﹤0.05）。고제량록필격뢰치료조환자결혈사건、재경사화혈전형성등병발증적발생솔현저저우대조조（ P﹤0.05）。결론 PCI환자술전복용고부하제량록필격뢰교상규부하제량예치료능경대정도억제직접치료후적조기혈소판응집정황。가현저개선림상예후，강저불양심혈관사건적발생솔，차병불증가출혈풍험，치료안전유효。
Objective To observe the short-term efficacy and safety of high loading dose of clopidogrel on proposed percutaneous coronary intervention( PCI)patients. Methods One hun-dred and forty-four patients undergoing coronary intervention were divided into observation group and con-trol group,according to the random number table. Observation group was given preoperatively high load-ing dose of clopidogrel( 600 mg ),administered at draught;The control group received conventional 300 mg,administered at draught. Maximum platelet aggregation rate( MPAR)before and after taking the medication was detected and compared,30 d postoperative clinical cardiovascular events and major bleeding events were observed. Results In the observation group,after taking 2 hours maximum platelet aggregation rate declined dramatically(P﹤0. 05),after taking 4 h,maximum platelet aggregation rate of the two groups significantly declined. There were significant difference compared with that before treat-ment(P﹤0. 05). Patients treated with high-dose clopidogrel had less ischemic events,reinfarction and thrombosis and other complications than the control group( P ﹤0. 05 ). Conclusions Compared with conventional pre-treatment,taking high loading dose of clopidogrel before PCI has a greater degree of di-rect inhibition of platelet aggregation at early stage. And can significantly improve clinical outcomes and reduce the incidence of adverse cardiovascular events,and does not increase the risk of bleeding,so the treatment is safe and effective.