非ST段抬高型急性冠状动脉综合征患者经皮冠状动脉介入治疗术后强化抗血小板治疗临床效果The clinical effect study of intensive antiplatelet therapy in patients of acute non ST-segment elevation coronary syndrome after PCI
于凝,惠永明,马超,熊永红,仲崇星
摘要(Abstract):
目的观察非ST段抬高型急性冠状动脉综合征患者经皮冠状动脉介入治疗(PCI)术后应用不同剂量的氯吡格雷疗效和安全性。方法共入选急性非ST段抬高型冠状动脉综合征行PCI术的患者506例,计算机简单随机法分为标准组、强化组。标准组入院后给予氯吡格雷300mg顿服,后予75mg/d维持;强化组入院后给予300mg顿服,后予150mg/d口服至PCI术后5d,后75mg/d维持。所有患者均于入院、顿服氯吡格雷300mg后24h、术前及术后5d行ADP诱导的血小板聚集率(PA)检查。于入院及术后5d行血常规检查,观察血小板变化,并随访术后30d主要心血管事件和出血事件的发生情况。结果强化组术前及术后5d的PA明显下降,强化组术前及术后5d的PA(%)较标准组明显减低,差异具有统计学意义(t=18.3929,P<0.05;t=13.1384,P<0.005)。强化组与标准组比较30d主要心血管事件有减低趋势,但未见有统计学意义。两组TIMI出血事件未见有明显差异。结论强化抗血小板治疗可以明显抑制血小板聚集率,同时出血风险未见明显增加,是安全可行的。
关键词(KeyWords): 氯吡格雷;血管成形术,经腔,经皮冠状动脉;血小板聚集;急性冠状动脉综合征
基金项目(Foundation):
作者(Author): 于凝,惠永明,马超,熊永红,仲崇星
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