体外循环冠状动脉旁路移植术后联用阿司匹林、氯吡格雷与单用阿司匹林抗血小板治疗效果分析

Efficacy of aspirin combined with clopidogrel and aspirin alone on patients underwent coronary artery bypass grafting after cardiopulmonary bypass

目的 探讨阿司匹林与氯吡格雷联合用于体外循环冠状动脉旁路移植术（CABG）与单纯阿司匹林抗血小板治疗的效果.方法 选择2016年1月至2018年3月在郑州市第七人民医院行体外循环CABG治疗的50例患者做随机非盲实验,将患者分为两组,每组25例.Ⅰ组单用阿司匹林进行抗血小板治疗,Ⅱ组接受阿司匹林＋氯吡格雷方案治疗,观察评估两组的抗血小板效果.结果 两组手术时间、出血量及住院时间等比较差异未见统计学意义（P〉0.05）.两组术前血小板凝集率比较差异未见统计学意义（P〉0.05）;术后1、2 d,Ⅱ组血小板凝集率比Ⅰ组低,差异有统计学意义（P〈0.05）.两组不良反应差异未见统计学意义（P〉0.05）.结论 阿司匹林＋氯吡格雷方案治疗体外循环CABG患者,能够获得较单用阿司匹林更理想的抗血小板凝集效果,且方案安全可靠,值得推荐.

Objective To study the effects of aspirin combined with clopidogrel and aspirin alone on the antiplatelet therapy of extracorporeal circulation coronary artery bypass grafting （ CABG ） . Methods Fifty patients who were treated with extracorporeal circulation CABG in the Seventh People ＇s Hospital of Zhengzhou from January 2016 to March 2018 were selected for random non blind experiment , and the patients were divided into two groups , with 25 cases in each group .The patients in group I were treated with aspirin alone , and the patents in group II received aspirin plus clopidogrel .The antiplatelet effects of the two groups were observed .Results There was no significant difference between the two groups in operative time , bleeding volume or hospital stay （ P〉0.05 ） . There was no significant difference between the two groups in the platelet aggregation rate berore operation （ P〉0.05 ） .The platelet aggregation rates of group group II at 1 day, 2 days after operation were lower than those of group I （ P〈0.05 ） . There was no significant difference between the two groups in adverse reactions （ P〉0.05 ） .Conclusions Aspirin plus clopidogrel therapy for CABG patients with cardiopulmonary bypass can obtain more ideal antiplatelet aggregation effect than aspirin alone , and the scheme is safe and reliable.It is worth recommending .