冠脉介入治疗围手术期使用氯吡格雷的循证医学证据

Evidence based clopidogrel in percutaneous coronary intervention in perioperative period

目的总结氯吡格雷在冠脉介入治疗(PCI)患者中应用的循证医学证据。方法检索Pubmed、Cochrane Library、CNKI、中文科技期刊数据库、万方数据库从建库至2014年2月的有关文献,根据纳入相关标准进行文献收集,然后对其作用机制、有效性系统评价文献汇总分析。结果共纳入33篇meta分析文献,证实氯吡格雷在PCI患者中抗血小板治疗的有效性,认为其高剂量维持和高剂量负荷并采取预治疗的策略似乎更有益。结论氯吡格雷是临床应用广泛的抗血小板药物,虽存在一定的局限,但其与阿司匹林联用,目前在PCI患者中发挥着积极的作用。

Objective To summarize certain evidence based clopidogrel in patients undergoing percutaneous coronary intervention（PCI）. Methods We searched Pubmed, Cochrane Library, CNKI, Chinese Science and Technology Academic Journal and Wanfang database from establishment to February 2014, and the mechanism and effectiveness of clopidogrel were summarized. Results Thirty-three articles were included and confirmed the effectiveness of antiplatelet treatment in the patients undergoing PCI, and high dose maintenance and high dose load of clopidogrel in the pre-treatment were more useful. Conclusion Clopidogrel is broadly used as antiplatelet drug clinically. Although there are some limitations, it currently plays a positive role with aspirin in patients undergoing PCI.