氯吡格雷联合阿司匹林和重组人组织型纤溶酶原激酶衍生物治疗急性ST段抬高型心肌梗死的临床疗效

Clinical effects of Clopidogrel,Aspirin and recombinant human tissue-type plasminogen activator derivative in treatment of acute ST segment elevation myocardial infarction

目的:观察氯吡格雷联合阿司匹林和重组人组织型纤溶酶原激酶衍生物治疗急性ST段抬高型心肌梗死的临床疗效。方法:选取急性ST段抬高型心肌梗死患者92例,采用随机数字表法分为两组,对照组46例患者采用氯吡格雷联合阿司匹林治疗,观察组46例患者采用氯吡格雷、阿司匹林及重组人组织型纤溶酶原激酶衍生物联合治疗,比较两组患者生化指标改变、临床疗效及不良反应发生情况。结果:两组患者治疗后C反应蛋白、白介素6、血浆比黏度、血小板聚集率较治疗前降低(P<0.05)。两组患者治疗后肌酸激酶同工酶、左室射血分数、肌钙蛋白、E/A值较治疗前增加(P<0.05)。观察组患者治疗后C反应蛋白、白介素6、血浆比黏度、血小板聚集率低于对照组(P<0.05)。观察组患者治疗后肌酸激酶同工酶、左室射血分数、肌钙蛋白、E/A值高于对照组(P<0.05)。观察组患者临床疗效总有效率为95.7%,高于对照组的80.4%,差异有统计学意义(P<0.05)。两组不良反应发生率差异无统计学意义(P>0.05)。结论:氯吡格雷联合阿司匹林和重组人组织型纤溶酶原激酶衍生物治疗急性ST段抬高型心肌梗死的疗效显著。

Objective： To investigate clinical effects of Clopidogrel,Aspirin and recombinant human tissue-type plasminogen activator derivative in treatment of acute ST segment elevation myocardial infarction. Methods： 92 patients with acute ST segment elevation myocardial infarction were selected and divided into control group（ n = 46） and observation group（ n = 46） by the random number table method. The control group was treated with Clopidogrel and Aspirin,while the observation group was treated with Clopidogrel,Aspirin and recombinant human tissue plasminogen activator derivative. The changes in biochemical parameters,the clinical efficacies and incidence of adverse reactions of the two groups were compared. Results： After the treatment,the levels of CRP,interleukin-6,plasma viscosity,and platelet aggregation rate were lower in both groups than those before the treatment（ P〈0. 05）. After the treatment,the levels of creatine kinase isoenzyme,left ventricular ejection fraction,troponin,and E/A value in the two groups were higher than those before the treatment（ P〈0.05）. After the treatment,the levels of CRP,interleukin-6,plasma viscosity,and platelet aggregation rate in the observation group were lower than those in the control group（ P〈0.05）,and the levels of creatine kinase isoenzyme,left ventricular ejection fraction,troponin,and E/A value were higher than those in the control group（ P〈0. 05）. The total effective rate in the observation group was 95.7%,which was higher than that in the control group（ 80.4%）,and the difference was significant（ P〉0.05）. There was no significant difference in the incidence of adverse reactions between the two groups（ P〈0.05）. Conclusions：Clopidogrel,Aspirin and recombinant human tissue-type plasminogen activator derivatives are effective in the treatment of acute STsegment elevation myocardial infarction.