硫酸氢氯吡格雷片联合阿司匹林治疗急性心肌梗死的临床疗效及安全性观察

Clinical efficacy and safety of clopidogrel hydrogen sulfate tablets combined with aspirin in the treatment of acute myocardial infarction

目的探讨急性心肌梗死患者采取硫酸氢氯吡格雷片结合阿司匹林治疗的应用价值。方法选择2013年6月~2017年6月我院收治的64例急性心肌梗死患者作为研究对象,按照随机数字法分为研究组与对照组各32例。研究组采取硫酸氢氯吡格雷片结合阿司匹林,对照组仅采取阿司匹林治疗,比较两组患者临床效果。结果研究组总有效率为93.75%,明显高于对照组的81.25%(χ~2=7.143,P<0.05);两组患者血管再通率无明显差异(χ~2=0.198,P>0.05),但研究组再闭塞率较对照组降低(χ~2=5.924,P<0.05);且头痛、肠胃不适及肌痛等不良反应发生率均较对照组低(χ~2=9.191,7.143,13.333,P<0.05);治疗后两组患者凝血酶原时间(PT)、部分活化凝血酶原时间(APTT)及血小板计数(Plt)水平无明显差异(t=1.141,-0.234,-1.176,P>0.05),但与治疗前相比明显改善;研究组治疗后左室射血分数(LVEF)水平较对照组提高,差异有统计学意义(t=9.791,P<0.05)。结论急性心肌梗死患者采取硫酸氢氯吡格雷片结合阿司匹林治疗效果显著,缓解患者相关症状,明显减少血管再闭塞情况,对患者凝血功能影响较小,安全性较高,具有推广及应用的价值。

Objective To investigate the clinical value of aspirin in patients with acute myocardial infarction(AMI)treated with clopidogrel bisulfate tablets.Methods 64 patients with acute myocardial infarction admitted in our hospital from June 2013 to June 2017 were divided into study group(n=32)and control group(n=32),according to random number method.The study group was treated with clopidogrel bisulfate tablets combined with aspirin,and the control group was given aspirin treatment only.The treatment effect between two groups was compared.Results The total effective rate was 93.75%in the study group,which was significantly higher than 81.25%in the control group(χ2=7.143,P<0.05).There were no significant differences in the revascularization rate between the two groups(χ2=0.198,P>0.05).However,the re-occlusion rate of the study group was lower than that of the control group(χ2=5.924,P<0.05).The incidence of adverse reactions such as headache,gastrointestinal upset and myalgia was lower than that in the control group(χ2=9.191,7.143,13.333,P<0.05).There were no significant differences in the prothrombin time(PT),partial prothrombin time(APTT)and platelet count(Plt)between the two groups after treatment(t=1.141,-0.234,1.176,P>0.05).But the indicators significantly improved compared with those before treatment.The LVEF level of the study group was significantly higher than that of the control group after treatment(t=9.791,P<0.05).Conclusions The treatment of clopidogrel hydrogen sulfate tablets combined with aspirin in patients with acute myocardial infarction has a significant therapeutic effect,which can alleviate the symptoms and reduce the reocclusion of the patients.It has less influence on the coagulation function and higher safety,and has great value in popularization and application.