不同剂量氯吡格雷在冠状动脉支架术后的有效性及安全性临床观察

The Comparison of effectiveness and safety between the different doses of clopidogrel in the patients after percutaneous coronary intervention

目的探讨冠状动脉支架术后氯吡格雷50mg/d维持剂量的有效性及安全性。方法入选心绞痛接受冠状动脉药物洗脱支架植入术的患者119例,随机分为A组(氯吡格雷维持剂量75mg/d)和B组(氯吡格雷维持剂量50mg/d)。术前均给予300mg负荷量,术后A组给予75mg/d维持剂量口服至少1a,B组给予75mg/d至术后第30天,术后第31天始给予50mg/d维持剂量至少1a。研究终点为随访6个月的主要心血管事件(包括死亡、支架内血栓形成、支架内再狭窄、非致死性心肌梗死、靶血管血运重建)的发生率及不良反应。结果两组患者主要心血管事件差异无统计学意义(P>0.05);不良反应的发生率无统计学差异(P>0.05)。结论 PCI术后氯吡格雷50mg/d维持剂量可以有效地预防支架内血栓形成,不增加心血管事件及不良反应的发生。

Objective To investigate the effectiveness and safety of 50mg/d clopidogrel in the patients after percutaneous coronary intervention（PCI）. Methods A total of 119 patients with coronary heart disease（CHD） were randomly divided into two groups including group A（75mg/d）and group B（50mg/d）. 300 mg of clopidogrel were given to all patients on the day before PCI. 75 mg of clopidogrel was given for 1 year on group A,while 150 mg of clopidogrel were given for 30 days and 50 mg of clopidogrel as maintenance-dose for at least 1 year on group B. The end points included major adverse cardiac and cerebral events（including death, stent thrombosis, in-stent restenosis,non-fatal myocardial infarction, target vessel revascularization） and other adverse reactions. Results There was no significant difference in the incidence of major cardiovascular adverse effects and other side effects between two groups（P^0.05）.Conclusion The maintenance-dose of 50 mg/d clopidogrel can effectively prevent in-stent restenosis without increment of cardiovascular adverse effects.