CAJ | 학술논문

目的：：探讨双倍负荷剂量氯吡格雷短期应用对急性冠脉综合征( ACS )患者经皮冠状动脉介入治疗(PCI)的近期临床疗效及血清高敏C反应蛋白(hs-CRP)水平的影响。方法：选择符合标准的患者80例，随机分为观察组和对照组各40例，对照组应用常规剂量的氯吡格雷，观察组采用双倍负荷剂量，观察比较血清hs-CRP、冠状动脉血流、主要心血管不良事件及出血事件等。结果：两组患者靶病变血管平均狭窄程度及狭窄长度相似，差异无统计学意义( P>0.05)。服药前两组患者血清hs-CRP 浓度相似，差异无统计学意义(P>0.05)；术前及术后1d、术后7d、术后30d 观察组血清hs-CRP浓度均低于对照组，差异有统计学意义( P<0.05)；术后1d两组患者血清hs-CRP 浓度较本组服药前均升高，差异有统计学意义( P<0.05)。两组患者TIMI血流分级相似，差异无统计学意义( P>0.05)；而观察组患者TIMI心肌灌注分级优于对照组，差异有统计学意义( P<0.05)。观察组患者主要心血管事件发生率明显低于对照组，差异有统计学意义( P<0.05)。两组患者均未发生颅内出血和消化道出血发生。结论：双倍负荷剂量氯吡格雷可明显减轻ACS患者PCI术后炎症，改善冠状动脉血流，减少主要心血管不良事件，值得临床推广应用。
목적：：탐토쌍배부하제량록필격뢰단기응용대급성관맥종합정( ACS )환자경피관상동맥개입치료(PCI)적근기림상료효급혈청고민C반응단백(hs-CRP)수평적영향。방법：선택부합표준적환자80례，수궤분위관찰조화대조조각40례，대조조응용상규제량적록필격뢰，관찰조채용쌍배부하제량，관찰비교혈청hs-CRP、관상동맥혈류、주요심혈관불량사건급출혈사건등。결과：량조환자파병변혈관평균협착정도급협착장도상사，차이무통계학의의( P>0.05)。복약전량조환자혈청hs-CRP 농도상사，차이무통계학의의(P>0.05)；술전급술후1d、술후7d、술후30d 관찰조혈청hs-CRP농도균저우대조조，차이유통계학의의( P<0.05)；술후1d량조환자혈청hs-CRP 농도교본조복약전균승고，차이유통계학의의( P<0.05)。량조환자TIMI혈류분급상사，차이무통계학의의( P>0.05)；이관찰조환자TIMI심기관주분급우우대조조，차이유통계학의의( P<0.05)。관찰조환자주요심혈관사건발생솔명현저우대조조，차이유통계학의의( P<0.05)。량조환자균미발생로내출혈화소화도출혈발생。결론：쌍배부하제량록필격뢰가명현감경ACS환자PCI술후염증，개선관상동맥혈류，감소주요심혈관불량사건，치득림상추엄응용。
Objective:To investigate the effects of double loading dose of clopidogrel short-term admin-istrated on the serum hypersensitive C reactive protein ( hs-CRP ) level and the short-term therapeutic effects of percutaneous coronary intervention ( PCI) in acute coronary syndrome ( ACS) patients. Method:80 eligible patients were selected and randomly divided into observation group and control group, 40 patients in each group; the control group used conventional dose of clopidogrel, while the observation group used double loading dose of it, and the serum hs-CRP levels, coronary blood flows, chief cardiovascular adverse events and hemorrhage events were observed and compared. Result: The average stenosis lengths and de-grees of the affected blood vessels in the patients of the two groups were similar, and the differences were sta-tistically insignificant (P>0.05). The serum hs-CRP concentrations before drug administration in the pa-tients of the two groups were similar, and the difference was statistically insignificant ( P>0.05);before the surgery and in 1 day, 7 days and 30d after the surgery, the serum hs-CRP concentrations in the patients of the observation group were all lower than those of the control group, and the differences were statistically sig-nificant (P<0.05); 1 day after the surgery, the serum hs-CRP concentrations in the patients of the two groups were increased when compared with the intra-group concentrations before drug administration, and the differences were statistically significant ( P<0.05) . The TIMI flow classifications in the patients of the two groups were similar, and the difference was statistically insignificant ( P>0.05); while the TIMI myocardial perfusion classification in the patients of the observation group was better than that of the control group, and the difference was statistically significant ( P<0.05) . The incidence of chief cardiovascular adverse events in the patients of the observation group was significantly lower than that of the control group, and the difference was statistically significant (P<0.05). Intracranial hemorrhage and alimentary tract hemorrhage occurred in the patients of neither group. Conclusion: Double loading dose of clopidogrel can significantly lighten the postoperative inflammation, improve the blood flow of coronary artery and reduce the chief cardiovascular ad-verse events in ACS patients who underwent PCI, and consequently is worthy of clinical application.