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 Clinical Observation of Efficacy and Safety of Different Dose of Clopidogrel after Coronary Stenting

目的:探讨在冠状动脉支架术后最具有安全性及有效性的氯吡格雷剂量。方法:选取2011年1月-2013年1月本院收治的行冠状动脉支架术的120例患者,按照随机数字表法将其分为对照组和观察组各60例,观察组服用氯吡格雷600 mg,对照组服用氯吡格雷300 mg,维持一周,之后两组患者每日均服用氯吡格雷75 mg作为维持剂量,持续一个月,观察比较两组患者的有效性及安全性。结果:观察组的临床治疗总有效率93.3%明显高于对照组的71.7%,差异有统计学意义(P<0.05);两组治疗后肌钙蛋白水平均明显下降,但观察组下降更为明显,且观察组的心血管不良反应发生率6.67%明显低于对照组的20.0%,差异均有统计学意义(P<0.05)。结论:与使用氯吡格雷的起始剂量为300 mg相比,起始剂量为600 mg时临床疗效显著,可有效降低患者的肌钙蛋白水平及心血管不良反应的发生,具有安全性及有效性,是防止冠状动脉支架术后引发再次狭窄的有效药物,值得临床推广应用。

Objective： To investigate the analysis of clopidogrel in coronary stenting with safety and effectiveness. Method： 120 patients who underwent coronary stenting in our hospital from January 2011 to January 2013 were selected, they were randomly divided into the control group and the observation group, 60 cases in each group.The observation group was given 600 mg of clopidogrel, the control group was given 300 mg of clopidogrel, for a week, after all patients were given clopidogrel daily 75 mg as maintenance dose, for a month, the efficacy and safety between the two groups were observed and compared.Result： The clinical total effective rate of treatment in the observation group was 93.3%, it was significantly higher than 71.7% of the control group, troponin levels of the two groups after treatment were significantly decreased, but the observation group decreased more obviously; the cardiovascular adverse reaction rate ofthe observation group was 6.67%, it was significantly lower than 20.0% of the control group, the differences were statistically significant （ P〈0.05 ） .Conclusion： Compared with the initial dose of clopidogrel for 300 mg, when 600 mg of the initial dose of, the clinical curative effect is distinct, can effectively reduce the patient＇s level of troponin and cardiovascular adverse reaction, has the safety and effectiveness, is a effective drug to prevent restenosis after coronary stenting, is worthy of clinical application.