氯吡格雷预防冠心病介入治疗后心血管不良事件发生的临床效果

Clinical effect of clopidogrel in prevention of cardiovascular adverse events after coronary intervention

目的探究冠心病介入治疗后采用氯吡格雷对心血管不良事件发生的预防效果。方法选取2015年7月~2017年1月我院收治的84例接受介入治疗的冠心病患者作为研究对象,根据双盲法分为两组,每组各42例。对照组患者予以低分子肝素治疗,观察组患者予以氯吡格雷治疗,并对两组患者的活化部分凝血活酶时间、凝血酶时间、凝血酶原时间以及纤维蛋白原、用药后血栓素B2水平、心血管不良事件发生率以及治疗满意度进行对比。结果两组患者的活化部分凝血活酶时间、凝血酶时间、凝血酶原时间以及纤维蛋白原方面比较,差异均无统计学意义(P>0.05);用药后6、12 h及1 d,观察组患者的血栓素B2水平分别为(82.22±14.85)ng/L、(65.13±12.52)ng/L及(46.70±9.12)ng/L,均低于对照组的(93.15±16.49)ng/L、(75.42±15.01)ng/L及(66.91±11.04)ng/L,差异有统计学意义(P<0.05);观察组患者的心血管不良事件发生率(4.76%)低于对照组(26.18%),差异有统计学意义(P<0.05)。观察组患者的治疗满意度(97.62%)高于对照组(78.57%),差异有统计学意义(P<0.05)。结论冠心病介入治疗后采用氯吡格雷对心血管不良事件发生的预防效果显著。

Objective To explore the preventive effect of clopidogrel on adverse cardiovascular events（ACEs） after interventional treatment of coronary heart disease（CHD）. Methods Eighty-four CHD patients admitted to our hospital from July 2015 to January 2017 were selected as the subjects, and divided into two groups according to the double-blinding, with 42 cases in each group. In control group, patients were treated with low molecular weight heparin, while in observation group, clopidogrel was provided. The activated partial thromboplastin time, thrombin time, prothrombin and fibrinogen time, post-treatment thromboxane B2 level, incidence of ACEs, and treatment satisfaction were compared between the two groups. Results There was no significant difference in activated partial thromboplastin time, thrombin time,prothrombin or fibrinogen time between the two groups（P〈0.05）. After 6, 12 and 24-hour treatment, the thromboxane B2 levels in the observation group were（82.22±14.85） ng/L,（65.13±12.52） ng/L, and（46.70±9.12） ng/L respectively, all lower than those in the control group for（93.15±16.49） ng/L,（75.42±15.01） ng/L and（66.91±11.04） ng/L（P〈0.05）. The incidence of ACEs in the observation group was 4.76%, which was lower than that in the control group accounting for26.18%, with a significant difference（P〈0.05）. The treatment satisfaction from patients in the observation group was97.62%, higher than that in the control group accounting for 78.57%, with statistical significance（P〈0.05）. Conclusion The use of clopidogrel in interventional treatment of CHD has a significant effect on the prevention of ACEs.