高维持量氯吡格雷治疗对DES的ACS患者的长期疗效观察

Long Term Efficacy of High Maintenance Dose of Clopidogrel in the Treatment of ACS in Patients with DES

目的:分析行药物洗脱支架(drug eluting stent,DES)植入术的急性冠脉综合征(acute coronary syndrome,ACS)患者采用高维持量氯吡格雷治疗的长期疗效。方法:选取我科2010年1月至2013年1月成功首次接受药物洗脱支架DES植入术的急性冠脉综合征ACS患者共130例,使用随机数字表法简单随机分为两组,分别在术后口服阿司匹林的基础上,加用每日150mg氯吡格雷(150mg组)和75mg氯吡格雷(75mg组)。比较两组患者治疗前后的血小板聚集率和血小板水平、平衡法核素心血池显像指标和随访期间不良事件发生率。结果:150mg组治疗后1个月、6个月的最大血小板聚集率、晚期血小板聚集率和血小板计数低于75mg组,差异具有统计学意义(P<0.05)。150mg组治疗后1个月、6个月的LVEF、LPFR和LPER高于75mg组,LTPFR和LTPER低于75mg组,差异具有统计学意义(P<0.05)。150mg组的支架内血栓形成率为0.00%,低于75mg组6.15%,差异具有统计学意义(P<0.05)。结论:行DES的ACS患者采用高维持量氯吡格雷安全有效,可降低不良事件发生率。

Objective： To analyze the long-term efficacy of drug eluting stent acute （DES） in the treat-ment of acute coronary syndrome （ACS） patients.Methods： 130 patients with acute coronary syndrome were randomly divided into two groups, the patients were treated with DES （150mg group） and 75mg group （75mg group）.Two groups were treated with 150mg and.Results：The maximum platelet aggregation rate, platelet ag-gregation rate and platelet count in 150mg group after 1-month and 6-month treatment were lower than those of control group.The difference was statistically significant （P〈0.05）.The LVEF, LPFR and LPER in 150mg group after 1-month and 6-month treatment were higher than that in the 75mg group, and LTPFR and LTPER were lower than in the 75mg group.The difference was statistically significant （P〈0.05）.The stent thrombosis rate in the 150mg group was 0%, which was significantly lower than that in group 75mg （P〈0.05）.Conclu-sion： High maintenance dose of clopidogrel is safe and effective in ACS patients with DES , which can reduce the incidence of adverse events.