联合应用抗血小板药物对急性心肌梗死溶栓治疗的临床观察

Clinical Observation of Combination of Antiplatelet in Thrombolytic Therapy for Patients with AMI

目的:观察急性心肌梗死患者接受标准治疗的基础上早期应用氯吡格雷治疗的疗效和安全性。方法:将160例ST段抬高型急性心肌梗死病人在标准治疗的基础上随机分为标准组和联合组。两组均接受尿激酶150万IU 30m in静脉滴入溶栓治疗。溶栓前标准组给予阿斯匹林口服,联合组加服氯吡格雷。观察冠状动脉再通率、梗死后心绞痛发生率、再梗发生率、病死率、左室射血分数(LVEF)及出血的差别,观察30d。结果:30d时联合组再通率、LVEF高于标准组,差异有统计学意义,P<0.05,梗死后心绞痛发生率、再梗发生率、病死率、总出血事件低于标准组,差异有统计学意义P<0.05。结论:联合抗血小板治疗可改善急性心肌梗死患者溶栓后的临床症状和预后,提高生活质量。

Objective： To observe the effect and securit on thrombolytic therapy in patients with acute myocardial infarction.Method： This study consisted of 160 patients with acute ST-segment elevation myocardial infarction who were randomly divided into standard group and combination group.Both groups received 1.5 million IU of urokinase for 30min intravenous infusion thrombolytic therapy.Before starting the thrombolysis,aspirin was given to all the patients,but clopidogrel was added to patients in the combination group only.The difference of the recanalization of the coronary artery,post-infarction angina pectoris,reinfarction,case fatality rate,LVEF,hemorrhage were observerd.Result： The recanalization of the coronary artery,LVEF were higher,while post-infarction angina pectoris,reinfarction,fatality rate,hemorrhage were lower in the combination group than those in the standard group（P〈 0.05）.Conclusion：Joint antiplatelet therapy can improve the prognosis and long-term effect in AMI,and improve the quality of life.