氯吡格雷冶疗非ST段抬高急性冠脉综合证临床观察

Clinical effects of clopidogrel on patiens with acute coronary syndrome without ST-segment elevation

目的观察氯吡格雷治疗非ST段抬高急性冠脉综合症（ACS）的临床效果及安全性。方法将82例符合非ST段抬高ACS的患者随机分为治疗组（42例）和对照组（40例）。对照组常规使用冠心病二级预防药物，治疗组在对照组治疗基础上加用氯吡格雷，首次负荷量300mg，以后75mg，1次／d，随访时间6个月，观察两组第1周心绞痛控制情况与6个月内心血管事件发生率及出血情况，观察治疗前后血小板聚集率、全血粘度、血浆粘度、凝血酶原时间（PT）、活化部分凝血酶原时间（APTT）。结果治疗组用药第1周心绞痛控制情况及6个月内心血管事件发生率均优于对照组（P〈0．05），出血事件发生率两组间差异无显著性（P〉0．05），两组均有降低血小板聚集率、全血粘度和血浆粘度作用，但治疗组效果更好（P〈0．01），治疗前后PT、APTT两组均无明显变化（P〉0．05）。结论氯毗格雪治疗非ST段抬高ACS是安全有效的。

Objective To observe the effect of prison beds and security of the clopidogrel teatment for without ST-segment elevation acute coronry syndrome（ACS）. Methods 82 patiens with without ST-segment elevation ACU were divided into treatment group（42 cases）and the control group（40 cases）at random. Then provided the control group with conventional secondary drugs of prevention coronary heart disease, while providing the treatment group with clopidogrel additionally based on the control group,the first load of 300 mg,later 75 mg,once a day. With six months following up ,observed the controling situation of angina for the first week, and the incidence of cardiovascular events and bleeding for the six months in both groups ;Observed platelet aggregation, whole blood viscosity,plasma viscosity,prothroinbin time（PT） and activated partial thromboplastin time（APTr） before and after the tratment. Results Both the controling situation of angina for the first week and the incidence of cardiovascular events for six months are better than the control group （ P 〈 0. 05 ）. The incidence of bleeding events has no significant between the two groups （ P 〉 0. 05 ）. Although the two groups have reduced latelet aggregation, whole blood viscosity and plasma viscosity, the treatment group has achieved a better effect（ P 〈 0. 01 ）. There are no singnificant changes about PT, Aptly before and after treatment（ P 〉 0.05 ）. Conclusion It＇ s safe and effctive to use clopidogrel to treat without ST-segment elevation ACS.