氯吡格雷不同给药方案预防经皮冠状动脉介入治疗术后心血管事件疗效观察

Effect of Clopidogrel Different Treatment Programs on Preventing Cardiovascular Events After Percutaneous Coronary Intervention

目的比较冠心病介入治疗中氯吡格雷两种给药方案预防心血管事件的有效性和安全性。方法对245例择期行冠状动脉介入治疗的患者进行回顾性分析。观察组(120例)于术前48 h及24 h分别给予氯吡格雷300 mg和225 mg双重负荷量,以后按常规口服75 mg每天1次;对照组(125例)于术前6 h给予氯吡格雷300 mg单负荷量,以后按常规口服75 mg每天1次。随访3个月,统计两组出现心血管事件、血栓形成以及出血并发症的情况。结果治疗3个月两组出凝血功能相似(P>0.05);治疗后观察组缺血性事件及血栓形成发生率均显著低于对照组(P<0.01);两组出血发生率差异无显著性(P>0.05),均无需停药。结论冠心病患者行择期冠状动脉介入治疗时,术前给予双重负荷量氯吡格雷可降低再缺血性事件及血栓形成发生率,而且安全性良好,是值得进一步研究的给药方案。

Aim To compare efficacy and safety of clopidogrel two treatment programs on preventing cardiovaseular events after percutaneous coronary intervention. Methods 245 cases of patients undergoing coronary intervention were analyzed retrospectively. The patients of the observation group （120 cases） were given double of capacity elopidogrel 300 mg and 225 mg on the preoperative 48 h and 24 h respectively, then conventional oral 75 mg, qd; and the patients of the control group （125 cases） were given clopidogrel 300 mg on the preoperative 6 h single, then conventional oral 75 mg, qd. After three months, incidence rates of cardiovascular events, thrombosis and bleeding complications were compared between the two groups. Results After three months of treatment, blood coagulations of the two groups were similar （ P 〉 0.05）. The incidence of reischemic event and thrombosis in observation group was sigcantly lower compared with the control group （ P 〈 0.01 ）, but the incidences of bleeding of the two groups had no significant difference （ P 〉 0.05 ）. Nobody was obliged to stop treating for drug side-effects. Conclusion giving double load of clopidogrel to patients with coronary heart disease undergoing coronary intervention before operation can reduce the incidences of reischemic event and thrombosis, and is safe.