低分子肝素联合阿司匹林、氯吡格雷治疗心肌梗死的临床效果

Clinical effect of low molecular weight heparin combined with aspirin and clopidogrel in the treatment of myocardial infarction

目的探讨低分子肝素联合阿司匹林、氯吡格雷治疗心肌梗死的临床效果及对炎症因子水平的影响。方法回顾性分析我院2015年3月至2016年3月收治的74例ST段抬高型心肌梗死患者的临床资料,根据治疗方法不同将其分为观察组(40例,给予低分子肝素联合阿司匹林、氯吡格雷治疗)和对照组(34例,给予低分子肝素与阿司匹林治疗)。比较两组患者治疗前、后凝血功能指标、炎症因子水平、血液流变学指标及临床疗效。结果治疗后,两组患者PLT均显著减少,APTT、PT均显著延长,且观察组均优于对照组,差异具有统计学意义(P<0.05);两组的IL-6、CRP及TNF-α水平均显著降低,且观察组低于对照组,差异具有统计学意义(P<0.05);两组高切全血粘度、低切全血粘度及红细胞聚集指数均降低,且观察组均低于对照组,差异具有统计学意义(P<0.05);观察组的治疗总有效率为90.00%,高于对照组的67.65%,差异具有统计学意义(P<0.05)。结论低分子肝素联合阿司匹林、氯吡格雷治疗心肌梗死的临床效果显著,其能有效改善患者凝血功能,减轻机体炎症反应,改善患者的血液流变学指标,值得临床推广。

Objective To explore the clinical effect of low molecular weight heparin combined with aspirin and clopidogrel in the treatment of myocardial infarction and its influence on the levels of inflammatory factors.Methods The clinical data of 74 patients with ST-segment elevation myocardial infarction admitted in our hospital from March 2015 to March 2016 were retrospectively analyzed.The patients were divided into observation group (40 cases, treated with low molecular weight heparin combined with aspirin and clopidogrel) and control group (34 cases, treated with low molecular weight heparin and aspirin).The coagulation function indexes, inflammatory factor levels, hemorheological indexes before and after treatment and clinical efficacy of the two groups were compared.Results After treatment, the PLT in both groups decreased significantly, APTT and PT prolonged significantly, and those in the observation group were superior to the control group, the differences were statistically significant (P<0.05);the levels of IL-6, CRP and TNF-α in the two groups decreased significantly, and those in the observation group were lower than the control group, the differences were statistically significant (P<0.05);the whole blood viscosity at high shear rate, whole blood viscosity at low shear rate and erythrocyte aggregation index in the two groups decreased, and those in the observation group were lower than the control group, the differences were statistically significant(P<0.05).The total effective rate of treatment of the observation group was 90.00%, which was higher than 67.65% of the control group, and the difference was statistically significant (P<0.05).Conclusion Low molecular weight heparin combined with aspirin and clopidogrel in the treatment of myocardial infarction has a significant clinical effect, which can effectively improve the coagulation function of patients, alleviate body inflammation reactions, and improve the hemorheological parameters of patients.It is worthy of clinical promotion.