硫酸氢氯吡格雷结合阿司匹林双联抗血小板在冠心病伴房颤抗凝治疗中的应用效果探讨

Practical effect of clopidogrel bisulfate combined with aspirin in anticoagulant therapy of coronary heart disease complicated with atrial fibrillation

目的观察不同药物疗法治疗冠心病并发房颤的效果。方法 70例冠心病并发房颤患者,按照随机原则分为甲组及乙组,每组35例。甲组采用华法林钠治疗,乙组运用硫酸氢氯吡格雷+阿司匹林治疗。比较两组出血事件、使用质子泵抑制剂(PPI)、主要及次要终点事件发生情况及治疗前后房颤血栓危险度(CHA_2DS_2-VASc)、出血风险(HAS-BLED)评分。结果乙组PPI使用率14.29%、主要终点事件发生率2.86%均低于甲组的42.86%、25.71%,差异有统计学意义(P<0.05)。治疗后,两组患者CHA_2DS_2-VASc、HAS-BLED评分均低于治疗前,且乙组CHA_2DS_2-VASc评分(6.66±1.07)分、HAS-BLED评分(4.04±0.43)分低于甲组的(7.32±1.28)、(5.24±0.81)分,差异有统计学意义(P<0.05)。结论硫酸氢氯吡格雷联合阿司匹林治疗冠心病并发房颤,疗效确切,值得推广。

Objective To observe the effect of clopidogrel bisulfate combined with aspirin in anticoagulant therapy of coronary heart disease complicated with atrial fibrillation.Methods A total of 70 cases of coronary heart disease complicated with atrial fibrillation were randomly divided into group A and group B,with 35 cases in each group.Group A was treated with warfarin sodium,and group B was treated with clopidogrel bisulfate and aspirin.The bleeding events,use of proton pump inhibitors(PPI),occurrence of primary and secondary end-points,and the CHA2DS2-VASc and HAS-BLED scores before and after treatment were compared between the two groups.Results The PPI utilization rate 14.29%and incidence of major end-points 2.86%of group B were lower than 42.86%and 25.71%of group A,and the difference was statistically significant(P<0.05).After treatment,the CHA2DS2-VASc and HAS-BLED score of the two groups were lower than those before treatment,and CHA2DS2-VASc score(6.66±1.07)points and HAS-BLED score(4.04±0.43)points of group B were lower than(7.32±1.28)and(5.24±0.81)points of group A.All the difference was statistically significant(P<0.05).Conclusion Combination of clopidogrel bisulfate and aspirin shows affirmative efficacy on the treatment of coronary heart disease complicated with atrial fibrillation,and is worthy of promotion.