PCI治疗前应用不同负荷剂量氯吡格雷对STEMI合并2型糖尿病患者的近期预后影响观察

Short-term Prognosis of Acute ST-segment Elevation Myocardial Infarction with Type 2 Diabetes Mellitus Treated with Sifferent Load Doses of Clopidogrel Combined with PCI

目的:分析不同负荷剂量氯吡格雷联合PCI治疗急性ST段抬高型心肌梗死(STEMI)合并2型糖尿病患者的近期预后情况,探讨超负荷剂量氯吡格雷在该类患者中的应用价值。方法:收集2015年10月-2018年10月期间我院急诊科收治的紧急行PCI治疗的急性ST段抬高型心肌梗死并2型糖尿病患者,分别从超负荷剂量和常规负荷剂量治疗的患者中各随机抽取45例患者,标记为观察组及对照组,比较2组的近期疗效与心脏不良反应和出血风险。结果:观察组治疗总的有效率为95.56%,明显高于对照组治疗总的有效率71.11%,差异有统计学的意义(P<0.05)。治疗后,观察组的主要心脏不良事件发生率明显低于对照组,差异有统计学的意义(P<0.05)。观察组与对照组的出血并发症发生率分别为6.67%与4.44%,差异没有统计学的意义(P>0.05)。结论:超负荷剂量氯吡格雷联合PCI治疗急性ST段抬高型心肌梗死合并2型糖尿病患者的近期预后效果好,可在临床中推广应用。

Objective:To analyze the short-term prognosis of patients with acute ST-segment elevation myocardial infarction(STEMI)complicated with type 2 diabetes mellitus treated with different load closes of clopidogrel combined with PCI and explore the application value of overload dose of clopidogrel in patients.Methods:STEMI complicated with type 2 diabetes mellitus treated with emergency PCI in emergency department of our hospital from October 2015 to October 2018 were investigated.45 patients randomly from each part of patients treated with overload dose or conventional load dose as the observation group and control group.Then the short-term efficacy,adverse cardiac reactions and bleeding risk between the two groups were compared.Results:The total effective rate of the observation group was significantly higher than that of the control group(95.56%vs 71.11%,PvO.05).After treatment,the incidence of major adverse cardiac events in the observation group was significantly lower than that in the control group(PV0.05).There was no significant difference in the incidence of complications between the two groups(6.67%vs 4.44%,P>0.05).Conclusion:Overload dose clopidogrel combined with PCI has good short-term prognosis in patients with acute ST-segment elevation myocardial infarction and type 2 diabetes mellitus,and can be widely used in clinic.