早期服用氯吡格雷对急性冠状动脉综合征患者介入治疗近期临床预后的影响Effect of early treatment with clopidogrel in patients with non-ST-elevation acute coronary syndrome undergoing early percutaneous coronary intervention
曹政,周玉杰,闫振娴,聂斌,张丽洁,周志明,卜聪亚
摘要(Abstract)：
目的探讨冠状动脉(冠脉)介入治疗(PCI)术前早期使用氯吡格雷能否较术前临时用药进一步改善非ST段抬高的急性冠脉综合征(NSTE-ACS)患者的近期预后。方法将拟行早期PCI治疗的NSTE-ACS患者随机分为早期用药组和对照组。早期用药组272名患者于入院临床诊断明确后立即开始服用氯吡格雷(首次给负荷量300mg,后以75mg/d维持)。对照组共入选265名患者,于冠脉造影后决定选择PCI治疗时开始用药,首次服用氯吡格雷300mg,术后以75mg/d维持。比较两组在PCI术后30d内死亡、支架血栓、心肌梗死、再发心绞痛和靶血管血运重建等心脏不良事件(MACE)的发生率。结果两组患者在临床病情、冠脉病变及支架置入治疗等方面比较,差异无统计学意义。PCI术后30d内早期用药组死亡、支架血栓、心肌梗死和靶血管血运重建等联合事件的发生率显著低于对照组。结论PCI术前早期使用氯吡格雷能够明显减少NSTE-ACS患者心血管不良事件的发生率,显著改善患者PCI术后的近期预后。
关键词(KeyWords)： 冠状动脉疾病;血小板聚集抑制剂;血管成形术,经腔,经皮冠状动脉
基金项目(Foundation):
作者(Author): 曹政,周玉杰,闫振娴,聂斌,张丽洁,周志明,卜聪亚
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