经皮冠状动脉介入术(PCI)后长期联合应用阿司匹林和氯吡格雷的临床观察

Clinical Observation on Long-Term Symphysial Use of Aspirin and Clopidogrel after Percutaneous Cardiology Intervention

目的 观察PCI术后长期联合应用阿司匹林和氯吡格雷的疗效及安全性。方法 将行PCI的 166例非ST段抬高的急性冠脉综合征患者随机分为试验组 ( 85例 )和对照组 ( 81例 )。试验组在PCI术后长期联合应用 ( 3～ 12个月 ,平均 6个月 )阿司匹林和氯吡格雷至随访结束 ;对照组在PCI术后联合应用阿司匹林和氯吡格雷 1个月 ,以后长期应用阿司匹林。观察两组间主要心血管事件 (心血管性死亡、心肌梗死、心肌缺血复发进行靶血管再通治疗 )及出血事件 (严重出血、轻微出血 )的发生。结果 试验组发生 9例心血管事件 (心肌梗死 3例、靶血管再通治疗 6例 ) ;对照组发生 2 0例心血管事件 (心血管性死亡 1例 ,心肌梗死 5例 ,靶血管再通治疗 14例 ) ,两组间有显著性差异 (P <0 .0 5 ) ;两组间均无严重出血发生 ,轻微出血事件无显著性差异 ( 3vs 2 ,P >0 .0 5 )。结论 PCI术后长期联合应用阿司匹林和氯吡格雷安全、有效 ,可减少PCI术后心血管事件的发生 。

Objective To investigate the clinical effect and the security of long-term symphysial use of aspirin and clopidogrel after percutaneous cardiology intervention(PCI).Method 166 patients with non-ST-elevation acute coronary syndrome undergoing PCI were randomly divided into test group(85 cases) and control group(81 cases).After PCI therapy the test group took clopidogrel and aspirin for 3～12 months(mean 6 months),the control group received clopidogrel and aspirin for 1 month and long-term treatment of aspirin.The occurrence of major cardiovascular events(including cardiovascular death,myocardial infarction and target-vessel revascularisation) and bleeding in patients was investigated.Results There were 9 major cardiovascular events(3 cases of myocardial infarction and 6 cases of target-vessel revascularisation) in test group and 20 in control group(1 case of cardiovascular death,5 cases of myocardial infarction and 14 cases of target-vessel revascularisatin)(P<0.05).There was no serious bleeding in two group and there was no significant difference in slight bleeding between two groups(3 vs 2,P<0.05).Conclusions The long-term use of aspirin and clopidogrel after PCI is safe and effective.It may reduce the major cardiovascular events and doesn't increase the bleeding.