摘要
目的探讨不同剂量氯吡格雷对急性冠状动脉综合征(ACS)患者氯吡格雷抵抗(CR)、血小板聚集率(PA)及炎性因子水平的影响。方法选择98例ACS患者,分为观察组和对照组,每组49例。两组均常规行经皮冠状动脉介入治疗(PCI),对照组给予低负荷量氯吡格雷配合治疗,而观察组给予高负荷剂量氯吡格雷配合治疗,分别于服药前及服药后2、6、24和48h测定血小板聚集率(PA)、超敏C反应蛋白(hs-CRP)水平,并评估氯吡格雷抵抗(CR)的发生情况。结果观察组CR发生率明显低于对照组,差异具有统计学意义(P<0.05)。两组服药后PA均显著低于服药前,而观察组患者服药后2、6、24h显著低于对照组(P<0.05);两组服药6h后hs-CRP水平均较服药前显著降低,而观察组在服药后6h和24h时hs-CRP水平显著低于对照组(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论高剂量的氯吡格雷对ACS患者具有更好的疗效,能够更加有效地抑制血小板聚集,降低CR发生率及炎性因子水平,且不良反应较少,得临床大力推广和应用。
Objective To explore the effects of different dose of clopidogrel on clopidogrel resistance,platelet aggregation rate and inflammatory factor level of patients with acute coronary syndrome.Methods Totally 98 cases of acute coronary syndrome patients were randomly divided into the observation group and the control group two groups according to the order of treatment,49 cases in each group.The two groups were treated with conventional percutaneous coronary artery intervention（PCI）,and the control group was treated with low dose clopidogrel,while the observation group was given high loading dose of clopidogrel.The determination of platelet aggregation rate（PA）and inflammatory factor hypersensitive C-reactive protein（hs-CRP）level respectively before treatment and after treatment 2,6,24 and 48hwere observed,and the clopidogrel resistance（CR）occurrence of two groups were assessed.Results The CR of observation group was significantly lower than the control group,the difference statistically significant（P〈0.05）.The rate of platelet aggregation of two groups after taking were significantly lower than that before treatment and the observation group patients after taking 2,6,24 h,platelet aggregation rate was significantly lower than the control group（P〈0.05）.The hs-CRP levels with 6hof two groups were significantly lower than before treatment,and the hs-CRP levels with 6h and 24 hof observation group were significantly lower than those of control group（P〈0.05）.The incidence of adverse reactions had no significant difference between two groups（P〉0.05）.Conclusion High dose of clopidogrel has better curative effect in patients with acute coronary syndrome,and can more effectively inhibit platelet aggregation,reduce the incidence of clopidogrel resistance and the levels of inflammatory factors,fewer adverse reactions,and worth the clinical promotion and application.
出处
《重庆医学》
CAS
北大核心
2015年第33期4658-4659,4662,共3页
Chongqing medicine
关键词
冠状动脉疾病
氯吡格雷抵抗
血小板聚集率
炎性因子
coronary artery disease
clopidogrel resistance
platelet aggregation rate
inflammatory factor
