不同剂量氯吡格雷在冠心病患者介入术后应用效果比较.docVIP

不同剂量氯吡格雷在冠心病患者介入术后的应用效果比较 　　[摘要] 目的 研究不同剂量氯吡格雷在冠心病患者介入术后的应用效果。 方法 选取我院2013年7月～2014年9月收治的100例骨折的冠心病患者为研究对象，随机分为2组，每组50例。对照组应用氯吡格雷首剂用量300 mg；观察组应用氯吡格雷首剂用量600 mg。比较两组患者术后校正TIMI计帧数（CTFC）、心肌型肌酸激酶同工酶（CK-MB）峰值及峰值时间、术后心肌灌注分级（TMPG）、无复流发生率、心电图ST段回落指数（STR）、入院时和术后6个月主要心血管事件（MACE）及用药后不良反应发生率。 结果 观察组无复流率为12.0%，低于对照组的28.0%，观察组STR≥50的为92.0%，高于对照组的76.0%，差异有统计学意义（P0.05）。观察组CTFC（20.32±4.61）帧，低于对照组的（31.33±5.23）帧，观察组CK-MB峰值（76.31±32.65）U/L，低于对照组的（120.87±43.23）U/L，观察组CK-MB峰时间（11.46±2.98）h，短于对照组的（17.12±3.49）h，差异有统计学意义（P0.05）。观察组术后6个月MACE发生率为8.0%，低于对照组的24.0%，差异有统计学意义（P0.05）。 结论 大剂量氯吡格雷能显著减少患者无复流的发生，改善患者心肌灌注，有助于患者的预后，在冠心病介入治疗中有较高的应用效果。 　　[关键词] 氯吡格雷；不同剂量；冠心病患者；介入术 　　[中图分类号] R681.5+2 [文献标识码] A [文章编号] 1674-4721（2016）02（a）-0126-03 　　Application effect comparison of clopidogrel in different doses in coronary heart disease patients after interventional treatment 　　YAN Deng-ke 　　The Second Department of Cardiology，the First People′s Hospital of Pingdingshan City in Henan Province，Pingdingshan 467000，China 　　[Abstract] Objective To observe application effect of clopidogrel in different doses in coronary heart disease（CHD） patients after interventional treatment. Methods From July 2013 to September 2014，100 CHD patients with bone fracture admitted into our hospital were selected as research objects and evenly divided into two groups in random.In control group，300 mg clopidogrel in first dosage was applied.In observation group，600 mg clopidogrel in first dosage was prescribed.Corrected timi frame count（CTFC），peak value and time of creatine kinase-MB（CK-MB），TIMI myocardial perfusion grading（TMPG），incidence of no-reflow，ST-segment resolution（STR），major advent cardiovascular event after admission and 6 months after surgery，and incidence of adverse drug reaction were compared between two groups. Results Rate of no-reflow in the observation group was 12.0%，lower than that in the control group accounting for 28.0%.In the observation group，STR over 50 was 92.0%，much higher than 76.0% in the control