阿司匹林联合氯吡格雷在急性心肌梗死溶栓前负荷给药中的应用效果

Application effect of aspirin combined with clopidogrel as preload drug administration in thrombolysis in acute myocardial infarction

目的研究急性心肌梗死溶栓前负荷应用拜阿司匹林及氯吡格雷对溶栓开通率的影响。方法选取2013年1月-2015年1月我院收治的60例急性ST段抬高型心肌梗死患者为研究对象,将其随机平均分为两组,两组患者均给予溶栓药物尿激酶22 000 U/kg,对照组30例在溶栓前给予300 mg拜阿司匹林嚼服,治疗组30例在此基础上加用300 mg氯吡格雷嚼服,溶栓后根据心电图、临床表现、心肌标志物等指标对两组患者溶栓治疗效果进行对比分析。结果对照组溶栓开通率为63.3%,治疗组溶栓开通率为93.3%,两组比较,差异有统计学意义（P〈0.05）;两组并发症差异无统计学意义（P〉0.05）。结论急性心肌梗死溶栓前负荷联合应用拜阿司匹林及氯吡格雷可有效提高静脉溶栓的开通率,降低患者急性心肌梗死急性期死亡率,为择期PCI赢得时间,具有临床推广价值。

Objective To study and analyze the influence of bayaspirin combined with clopidogrel as preload drug administration in thrombolysis in acute myocardial infarction on reperfusion rate of thrombolysis. Methods From January2013 to January 2015,60 patients with acute ST segment elevation myocardial infarction admitted into our hospital were selected as research objects.They were evenly divided into two groups in random.Urokinase（22 000 U/kg） as a thrombolytic drug was used in both groups.In the control group,300 mg bayaspirin as chewing before thrombolysis was provided,while in the treatment group,300 mg clopidogrel was added.After thrombolysis,the therapeutic effect was comparatively analyzed based on the indexes of electrocardiogram,clinical manifestations,and cardiac markers. Results The reperfusion rate of thrombolysis in the control group was 63.3%,while the rate in the treatment group was 93.3%,with a statistical difference after comparison（P〈0.05）.Complications occurred between two groups in comparison was no statistical difference（P〉0.05） Conclusion Joint application of bayaspirin and clopidogrel as preload drug administration in thrombolysis in acute myocardial infarction can effectively increase reperfusion rate of intravenous thrombolysis and reduce mortality rate at acute stage in patients with acute myocardial infarction, and get time for percutaneous coronary intervention（PCI）,which has a promotional value in clinic.