CAJ | 학술논문

目的：观察氯吡格雷联合阿司匹林治疗老年人冠心病及对相关指标的影响。方法回顾性分析200例老年冠心病患者临床资料，根据治疗方法不同分为两组，每组100例。两组均在常规稳定斑块、扩张冠脉的基础上行针对性治疗，对照组采用口服阿司匹林肠溶片治疗，观察组采用阿司匹林联合氯吡格雷片治疗。观察两组临床疗效、治疗前后心功能指标、凝血指标以及不良反应发生情况。结果观察组临床总有效率为93．0％，显著高于对照组的77．8％（χ2＝4．142，P＜0．05）；观察组治疗后心功能指标LVEF、SV、CO显著高于对照组（t＝2．475、2．397、3．052，均P＜0．05）；两组治疗后MAADP、血小板抑制率、血小板聚集率等指标与治疗前差异均有统计学意义（t＝8．293、12．285、10．384，均P＜0．05）；观察组治疗后MAADP、血小板抑制率、血小板聚集率等指标与对照组治疗后差异均有统计学意义（t＝6.682、8．668、8．051，均P＜0．05）；对照组和观察组治疗后FIB水平与治疗前差异均有统计学意义（t＝2．375、4．393，均P＜0．05）；观察组治疗后血浆FIB水平与对照组治疗后比较差异均有统计学意义（t＝2.186，P＜0．05）；对照组和观察组治疗后TC、TG、HGL、LDL等指标水平与治疗前差异均有统计学意义（t＝3．226、2．834、2．448、3．298、3．006、2．927、2．446、3.695，均P＜0．05）；观察组再发冠心病、再次入院人数均优于对照组（χ2＝4．126、8．256，均 P＜0．05）。结论氯吡格雷联合阿司匹林能够通过更加有效地抗血小板聚集及抑制凝血功能达到快速、高效抗栓作用，提高冠心病治疗的临床疗效及心功能，且短期使用安全性良好。
목적：관찰록필격뢰연합아사필림치료노년인관심병급대상관지표적영향。방법회고성분석200례노년관심병환자림상자료，근거치료방법불동분위량조，매조100례。량조균재상규은정반괴、확장관맥적기출상행침대성치료，대조조채용구복아사필림장용편치료，관찰조채용아사필림연합록필격뢰편치료。관찰량조림상료효、치료전후심공능지표、응혈지표이급불량반응발생정황。결과관찰조림상총유효솔위93．0％，현저고우대조조적77．8％（χ2＝4．142，P＜0．05）；관찰조치료후심공능지표LVEF、SV、CO현저고우대조조（t＝2．475、2．397、3．052，균P＜0．05）；량조치료후MAADP、혈소판억제솔、혈소판취집솔등지표여치료전차이균유통계학의의（t＝8．293、12．285、10．384，균P＜0．05）；관찰조치료후MAADP、혈소판억제솔、혈소판취집솔등지표여대조조치료후차이균유통계학의의（t＝6.682、8．668、8．051，균P＜0．05）；대조조화관찰조치료후FIB수평여치료전차이균유통계학의의（t＝2．375、4．393，균P＜0．05）；관찰조치료후혈장FIB수평여대조조치료후비교차이균유통계학의의（t＝2.186，P＜0．05）；대조조화관찰조치료후TC、TG、HGL、LDL등지표수평여치료전차이균유통계학의의（t＝3．226、2．834、2．448、3．298、3．006、2．927、2．446、3.695，균P＜0．05）；관찰조재발관심병、재차입원인수균우우대조조（χ2＝4．126、8．256，균 P＜0．05）。결론록필격뢰연합아사필림능구통과경가유효지항혈소판취집급억제응혈공능체도쾌속、고효항전작용，제고관심병치료적림상료효급심공능，차단기사용안전성량호。
Objective To observe the effect of clopidogrel in combination with aspirin to treat senile coro-nary heart disease and its influence on relevant indicators.Methods Clinical data of 200 elderly patients with coro-nary heart disease(CHD)were retrospectively analyzed,according to different therapeutic methods,they were divided into the two groups,100 cases in each group,the two groups on the basis of conventional stable plaques,expand coro-nary targeted treatment,the control group treated with oral aspirin enteric -coated metformin hydrochloride,the observation group treated with aspirin combined clopidogrel treatment.The clinical efficacy of the two groups,the cardiac function indexes before and after treatment,blood coagulation indexes,as well as the adverse reaction of the two groups of patients were observed.Results The total effective rate of the observation group was 93.0%,which was significantly higher than 77.8%of the control group(χ2 =4.142,P<0.05);In the observation group after treatment, the cardiac function indexes LVEF,SV,CO were significantly higher than the control group(t=2.475,2.397,3.052, all P<0.05);The MAADP,platelet inhibition rate after treatment in both groups before treatment and platelet aggre-gation rate and other indicators and comparative differences were statistically significant(t=8.293,12.285,10.384, all P<0.05 );In the observation group after treatment,the MAADP,platelet inhibition rate and platelet aggregation rate index difference compared with the control group after treatment were statistically significant(t=6.682,8.668, 8.05 1 ,all P<0.05 );In the two groups,the FIB levels after treatment compared with before treatment differences were statistically significant(t=2.375,4.393,all P<0.05);In the observation group after treatment,the plasma FIB level compared with the control group after treatment differences was statistically significant(t=2.186,P<0.05);In the two groups after treatment,the indexes of TC,TG,HGL and LDL levels compared with before treatment differences were statistically significant(t=3.226,2.834,2.448,2.834,3.006,2.927,2.446,2.927,all P<0.05);Again hair the comparison of the number of coronary heart disease,readmission,the observation group was better than that of control group(χ2 =4.126,8.256,all P<0.05 ).Conclusion Clopidogrel in combination with aspirin can more effectively by platelet aggregation and inhibit blood coagulation function to achieve fast and efficient antithrombotic effect,improve the treatment of coronary artery disease clinical curative effect and heart function,and short-term use safety is good.