医学综述
醫學綜述
의학종술
MEDICAL RECAPITULATE
2014年
24期
4558-4560
,共3页
剂量%氯吡格雷%替罗非班%急性心肌梗死
劑量%氯吡格雷%替囉非班%急性心肌梗死
제량%록필격뢰%체라비반%급성심기경사
Dose%Clopidogrel%Tirofiban%Acute myocardial infarction
目的：探讨不同剂量氯吡格雷与替罗非班联用治疗急性心肌梗死的临床效果,为临床治疗剂量选择提供依据。方法选取博兴县第二人民医院心内科2010年5月至2012年1月收治急性心肌梗死患者180例,采用随机数字表法分为小剂量组和大剂量组,各90例。其中小剂量组患者采用氯吡格雷350 mg+替罗非班联合治疗；大剂量组患者采用氯吡格雷600 mg+替罗非班联合治疗。比较两组患者治疗前后血浆可溶性CD40配体(sCD40L)、血小板源性生长因子-BB(PDGF-BB)指标, ST段下降幅度,缺血导联个数及不良心脏事件发生情况。结果治疗前,小剂量组和大剂量组患者血浆sCD40L、PDGF-BB水平,ST段下降幅度及缺血导联个数比较差异无统计学意义(P>0.05)；治疗后,两组患者血浆sCD40 L、PDGF-BB水平,ST段下降幅度及缺血导联个数较治疗前均显著降低,且大剂量组患者治疗后上述各指标均显著低于小剂量组[(150.3±26.9)μg/L vs (194.5±33.4)μg/L,(2071.7±577.8)μg/L vs (2564.2±623.6)μg/L,(0.33±0.09) mm vs (0.65±0.14) mm,(1.74±0.48)个 vs(2.86±0.87)个],差异均有统计学意义(P<0.05)；同时大剂量组患者心绞痛再发、心肌梗死再发及病死率均低于小剂量组(8.9% vs 23.3%,1.1% vs 11.1%,1.1% vs 8.8%),组间比较差异有统计学意义(P<0.05)。结论大剂量氯吡格雷与替罗非班联用治疗急性心肌梗死相较于常规剂量可有效改善心肌缺血,减少不良心脏事件发生风险。
目的：探討不同劑量氯吡格雷與替囉非班聯用治療急性心肌梗死的臨床效果,為臨床治療劑量選擇提供依據。方法選取博興縣第二人民醫院心內科2010年5月至2012年1月收治急性心肌梗死患者180例,採用隨機數字錶法分為小劑量組和大劑量組,各90例。其中小劑量組患者採用氯吡格雷350 mg+替囉非班聯閤治療；大劑量組患者採用氯吡格雷600 mg+替囉非班聯閤治療。比較兩組患者治療前後血漿可溶性CD40配體(sCD40L)、血小闆源性生長因子-BB(PDGF-BB)指標, ST段下降幅度,缺血導聯箇數及不良心髒事件髮生情況。結果治療前,小劑量組和大劑量組患者血漿sCD40L、PDGF-BB水平,ST段下降幅度及缺血導聯箇數比較差異無統計學意義(P>0.05)；治療後,兩組患者血漿sCD40 L、PDGF-BB水平,ST段下降幅度及缺血導聯箇數較治療前均顯著降低,且大劑量組患者治療後上述各指標均顯著低于小劑量組[(150.3±26.9)μg/L vs (194.5±33.4)μg/L,(2071.7±577.8)μg/L vs (2564.2±623.6)μg/L,(0.33±0.09) mm vs (0.65±0.14) mm,(1.74±0.48)箇 vs(2.86±0.87)箇],差異均有統計學意義(P<0.05)；同時大劑量組患者心絞痛再髮、心肌梗死再髮及病死率均低于小劑量組(8.9% vs 23.3%,1.1% vs 11.1%,1.1% vs 8.8%),組間比較差異有統計學意義(P<0.05)。結論大劑量氯吡格雷與替囉非班聯用治療急性心肌梗死相較于常規劑量可有效改善心肌缺血,減少不良心髒事件髮生風險。
목적：탐토불동제량록필격뢰여체라비반련용치료급성심기경사적림상효과,위림상치료제량선택제공의거。방법선취박흥현제이인민의원심내과2010년5월지2012년1월수치급성심기경사환자180례,채용수궤수자표법분위소제량조화대제량조,각90례。기중소제량조환자채용록필격뢰350 mg+체라비반연합치료；대제량조환자채용록필격뢰600 mg+체라비반연합치료。비교량조환자치료전후혈장가용성CD40배체(sCD40L)、혈소판원성생장인자-BB(PDGF-BB)지표, ST단하강폭도,결혈도련개수급불양심장사건발생정황。결과치료전,소제량조화대제량조환자혈장sCD40L、PDGF-BB수평,ST단하강폭도급결혈도련개수비교차이무통계학의의(P>0.05)；치료후,량조환자혈장sCD40 L、PDGF-BB수평,ST단하강폭도급결혈도련개수교치료전균현저강저,차대제량조환자치료후상술각지표균현저저우소제량조[(150.3±26.9)μg/L vs (194.5±33.4)μg/L,(2071.7±577.8)μg/L vs (2564.2±623.6)μg/L,(0.33±0.09) mm vs (0.65±0.14) mm,(1.74±0.48)개 vs(2.86±0.87)개],차이균유통계학의의(P<0.05)；동시대제량조환자심교통재발、심기경사재발급병사솔균저우소제량조(8.9% vs 23.3%,1.1% vs 11.1%,1.1% vs 8.8%),조간비교차이유통계학의의(P<0.05)。결론대제량록필격뢰여체라비반련용치료급성심기경사상교우상규제량가유효개선심기결혈,감소불양심장사건발생풍험。
Objective To investigate the therapeutic effect and safety of different dose clopidogrel com-bined with tirofiban for acute myocardial infarction for providing evidence of dose selection. Methods 180 patients with acute myocardial infarction in Cardiology Department of 2nd people′s hospital in Boxing County in the period from May 2010 to January 2012 were randomly assigned small dose group (90 patients) with clopidogrel for 350 mg combined with tirofiban and large dose group (90 patients) with clopidogrel for 600 mg combined with tirofiban;and the sCD40 L and PDGF-BB before and after treatment,decline degree of ST segment,number of ischemia lead and adverse cardiac events were assessed in both groups. Results There was no significant difference in the sCD40 L and PDGF-BB,decline degree of ST segment and number of is-chemialeadbeforetreatmentbetween2groups(P>0.05).ThesCD40LandPDGF-BB,declinedegreeof ST segment and number of ischemia lead of both groups after treatment were significantly lower than before treatment(P<0. 05);and the related indicators of acute myocardial infarction of large dose group were sig-nificantly lower than small dose group[(150.3 ±26.9) μg/L vs (194.5 ±33.4) μg/L,(2071.7 ±577. 8) μg/L vs (2564.2 ±623.6) μg/L,(0.33 ±0.09) mm vs (0.65 ±0.14) mm,(1.74 ±0.48)one vs (2.86±0.87)one].Therecurrentrateofanginaandmyocardialinfarctionandmortalityoflargedosegroup were significantly lower than small dose group(8. 9% vs 23. 3%,1. 1% vs 11. 1%,1. 1% vs 8. 8%)(P<0. 05). Conclusion Compared with clopidogrel for conventional dose,clopidogrel for large dose combined with tirofiban on acute myocardial infarction can efficiently improve myocardial ischemia and reducing the risk of adverse cardiac events.
