阿司匹林与氯吡格雷联合治疗冠状动脉慢血流疗效观察

CLINICAL EFFICACY OF COMBINED ASPIRIN AND CLOPIDOGREL THERAPY FOR CORONARY BLOOD FLOW

目的观察阿司匹林与氯吡格雷联合应用在冠状动脉慢血流中的治疗效果,研究和评价阿司匹林与氯吡格雷对冠状动脉慢血流的治疗作用。方法通过矫正的TIMI血流分级方法,评价冠状动脉血流速度,对124例冠状动脉慢血流患者随机分为阿司匹林组38例、氯吡格雷组42例、联合组44例,治疗前各组均行平板运动试验及心脏超声左室射血分数(LVEF)测定,治疗1个月后,再次评价冠状动脉血流速度、平板运动试验、心绞痛发作次数。结果三组治疗后在冠脉血流速度、平板运动试验、缓解心绞痛方面与治疗前相比差异有统计学意义(P均<0.01),联合组在冠脉血流速度、平板运动试验、缓解心绞痛与阿司匹林组及氯吡格雷组比较差异有统计学意义(P均<0.01),而阿司匹林组与氯吡格雷组在冠脉血流速度、次级量平板运动试验、缓解心绞痛方面比较差异有统计学意义(P=0.345、0.273、0.467)。结论联合应用阿司匹林与氯吡格雷抗血小板治疗能更好改善冠状动脉患者血流情况,抗血小板是冠状动脉慢血流有效的治疗方法。

Objective To observe the effect of aspirin and clopidogrel in the treatment of coronary slow flow, research and evaluate the curing for the disease. Methods Total 124 patients with coronary artery blood flow were evaluated by corrected TIMI flow grade methods, then were randomly divided into 38 cases of aspirin, 42 cases of clopidogrel, 44 cases of the combined group： The subjects who underwent exercise test and echocardiographic left ventricular ejection fraction （LVEF） before treatment. After one - month treatment,the coronary blood flow velocity, exercise test, angina attack times were evaluated again in the three groups. Results There were significant differences in coronary blood flow velocity, exercise test, re- lief＇of angina pectoris compared to pretherapy among the three groups（P^0.01）. The therapic efficacy for the coronary blood flow velocity, exercise test,ease of angina pectoris was higher in combined group than in aspirin group or clopidogrel group （P^0.01） ,but there was no differences between aspirin group and cio- pidogret group after treatment （P^0.05）. Conclusion Combined application of aspirin and clopidogrel can improve the coronary blood flow velocity much better,so the antiplatelet treatment is effective in the coro： nary blood flow. ＂