氯吡格雷治疗高龄冠心病患者的安全性

The safety of the clopidogrel in treating coronary heart disease in elderly patients

目的观察氯吡格雷治疗高龄老年冠心病患者的安全性。方法将入选口服氯吡格雷的患者按年龄分为3组:高龄老年组70例,年龄≥80岁,平均84.50±8.16岁;老年组60例,年龄60～79岁,平均76.50±7.16岁;对照组82例,年龄≤59岁,平均56.50±3.16岁。分别口服氯吡格雷75mg/d后6个月、12个月检测肝功、肾功、血小板计数、白细胞计数和中性粒细胞计数及血脂的变化,并观察各组发生胃肠道出血及其他不良反应,比较高龄老年组、老年组和对照组患者口服氯吡格雷的安全性。结果治疗前后3组患者肝功、肾功、血小板计数、白细胞计数、中性粒细胞计数结果差异无统计学意义(P>0.05)。3组患者均同时服用他汀类调脂药,总胆固醇和低密度脂蛋白胆固醇治疗后6个月、12个月低于治疗前(P<0.05),而治疗后6个月与治疗后12个月结果变化无统计学意义(P>0.05)。3组消化道出血的发生率无统计学意义(P>0.05)。结论高龄老年冠心病患者口服氯吡格雷安全性较好。

Objective To study the safety of the clopidogrel in treating coronary heart disease in elderly patients. Methods 212 coronary heart disease patients were divided into oldest old group,70 patients（range 80-92 years）,mean 84.50± 8.16 with CAD,old group with 60 patients aged 60-79 years old mean 76.50±7.16 and younger group with 82 patients 59 years old mean 56.50±3.16. All the patients treated with 75mg of clopidogrel. The blood lipid,the function of the liver and the kidney, platelet, leukocyte count, neutrophils （N） , the risk of upper gastrointestinal bleeding and other adverse effects were monitored before treatment and after treatment for 6 months and 12 months respectively. Results There was no significant difference in the function of the liver and the kidney,platelet,leukocyte count, N and gastrointestinal hemorrhage between 3 groups before the treatment and after 6 months and 12 months（P〉0.05）. The TC and LDL-C of blood lipid was lower than those before treatment （P〈 0.05）. There was no significant difference between after treatment 6 months group and 12 months group. Conclusions Clopidogrel is effective and safe in treating CAD in elderly patients.