不同剂量氯吡格雷治疗非ST段抬高急性心肌梗死疗效观察

Effect of different doses of clopidogrel on non-ST segment elevation myocardial infarction

目的:探讨不同剂量氯吡格雷对急性非ST段抬高心肌梗死(NSTEMI)患者的疗效及预后。方法:112例确诊为NSTEMI患者,随机分为治疗组(n=59)和对照组(n=53),治疗组用常规治疗加首次负荷剂量氯吡格雷300mg口服,随后1周150mg/d,第二周开始75mg/d,对照组用常规治疗加氯吡格雷每天口服75mg,比较两组的疗效及预后。结果:治疗组梗死后心绞痛、需血运重建及室速发生率低于对照组(P<0.05),而死亡、再梗死、脑卒中、休克、室颤、阵发性房颤发生率与对照组比较差异无显著性(P>0.05)。治疗组出血并发症、白细胞及血小板减少发生率与对照组比较差异无显著性(P>0.05)。结论:给予短期负荷量及较大剂量氯吡格雷治疗NSTEMI较小剂量具有更好的疗效,安全性好。

Objective：To investigate the effects and short-term prognosis of different doses of clopidogrel on the patients with nonST segment elevation myocardial infarction.Methods：112 patients with non-ST segment elevation myocardial infarction were randomly divided into two groups：the study group and the control group.The study group received 300mg loading dose clopidogrel followed by 150mg daily during the first week and 75 mg daily from the second week,while the control group received only 75mg clopidogrel daily from the beginning.The effects and short-term prognosis were analyzed and compared.Results：The study group presents a lower occurrence of post-AMI angina,ventricular tachycardia and a lower need of revascularization while compared with the control group.Howerer,the mortality,re-infarction,stroke,shock,ventricular fibrillation and paroxymal atrial fibrillation was found no difference in two groups.There was no significant differences in hemorrhagic events,granulocytopenia and thrombocytopenia between the two groups.Conclusion：Loading dose followed by higher doses of clopidogrel has a better short-term outcome than lower doses of clopidogrel in the patients with non-ST elevation myocardial infarction.