CAJ | 학술논문

目的：比较国产氯吡格雷与进口氯吡格雷治疗ST段抬高型心肌梗死的临床疗效。方法选取2013年11月—2014年11月泾县人民医院收治的87例ST段抬高型心肌梗死患者，按照随机数字表法分为对照组44例和治疗组43例。两组均给予溶栓、抗凝、调脂、抗心肌缺血治疗，治疗组同时给予阿司匹林联合国产氯吡格雷治疗，对照组给予阿司匹林联合进口氯吡格雷治疗。近期观察心肌梗死患者疾病进展情况、检测患者的心肌酶谱及血小板功能，远期记录患者心肌梗死再发情况。结果急性期随访21d两组心血管事件联合终点发生率、总有效率比较，差异无统计学意义（ P>0.05）。远期随访12个月，两组心脑血管事件联合终点发生率、心肌梗死再发率比较，差异无统计学意义（ P>0.05）。随访7d，两组心肌钙蛋白（ cTnI）、肌酸激酶同工酶（ CK-MB）异常持续时间、血小板聚集率比较，差异无统计学意义（ P>0.05）。两组患者出血反应、胃肠道不良反应、神经系统反应、粒细胞或血小板减少发生率比较，差异无统计学意义（ P>0.05），两组无法坚持12个月服用药物比例比较，差异有统计学意义（ P<0.05）。结论国产氯吡格雷近期应用可减轻心肌损伤，降低心肌梗死死亡风险，长期应用可预防心肌梗死再发，其临床疗效与安全性与进口氯吡格雷无明显差异。
목적：비교국산록필격뢰여진구록필격뢰치료ST단태고형심기경사적림상료효。방법선취2013년11월—2014년11월경현인민의원수치적87례ST단태고형심기경사환자，안조수궤수자표법분위대조조44례화치료조43례。량조균급여용전、항응、조지、항심기결혈치료，치료조동시급여아사필림연합국산록필격뢰치료，대조조급여아사필림연합진구록필격뢰치료。근기관찰심기경사환자질병진전정황、검측환자적심기매보급혈소판공능，원기기록환자심기경사재발정황。결과급성기수방21d량조심혈관사건연합종점발생솔、총유효솔비교，차이무통계학의의（ P>0.05）。원기수방12개월，량조심뇌혈관사건연합종점발생솔、심기경사재발솔비교，차이무통계학의의（ P>0.05）。수방7d，량조심기개단백（ cTnI）、기산격매동공매（ CK-MB）이상지속시간、혈소판취집솔비교，차이무통계학의의（ P>0.05）。량조환자출혈반응、위장도불량반응、신경계통반응、립세포혹혈소판감소발생솔비교，차이무통계학의의（ P>0.05），량조무법견지12개월복용약물비례비교，차이유통계학의의（ P<0.05）。결론국산록필격뢰근기응용가감경심기손상，강저심기경사사망풍험，장기응용가예방심기경사재발，기림상료효여안전성여진구록필격뢰무명현차이。
Objective To compare the clinical efficacy of domestic and imported clopidogrel in the treatment of myo-cardial infarction with ST -segment elevation. Methods In People's Hospital of Jing County from November 2013 to November 2014,87 myocardial infarction with ST -segment elevation patients were selected,according to the random number table they were randomly divided into control group(44 cases)and treatment group(45 cases). Two groups were given thrombolysis, anticoagulation,lipid treatment,treatment group were treated with aspirin combined with domestic clopidogrel,control group were treated with aspirin combined with imports clopidogrel. Recent disease progression of myocardial infarction,the detection of myocardial enzymes and platelet function,long-term recurrence of myocardial infarction records. Results 21d recent follow-up,the combined endpoint of cardiovascular events rates and total efficiency rates of two groups were compared,the differences were not statistically significant( P>0. 05). Long-term follow-up of 12 months,the combined endpoint of cardiovascular e-vents rates and myocardial infarction recurrence rates of two groups were compared,the differences were not statistically signifi-cant(P>0. 05). Cardiac troponin I(cTnI),creatine kinaseisoenzyme MB(CK-MB)abnormal duration,rate of platelet aggregation after 7d between the two groups showed no significant differences( P>0. 05). Incidence rate of hemorrhage,the gastro intestinal tract bad effect,nervous system reactions,granulocytopenia or thrombocytopenia between the two groups showed no significant differences(P>0. 05). Unable to insist on 12 months medication proportion between the two groups showed sig-nificant differences( P<0. 05). Conclusion The recent application of domestic clopidogrel can reduces myocardial damage, reduce the risk of myocardial infarction mortality. Long-term use can prevent recurrent myocardial infarction. The clinical effi-cacy and safety of clopidogrel with no significant difference between the import.