摘要
目的探讨双倍剂量氯吡格雷用于急性冠脉综合征(ACS)患者介入治疗后的效果。方法收集2015年1月—2018年12月天津市第四中心医院收治的ACS并经介入治疗的患者320例,随机分为对照组和观察组各160例。对照组组介入治疗术后12个月内常规应用阿司匹林100mg/d+氯吡格雷75mg/d进行抗血小板治疗。观察组介入治疗术后3个月内采用阿司匹林100mg/d+氯吡格雷150mg/d;3个月后改为阿司匹林100mg/d+氯吡格雷75mg/d进行抗血小板治疗9个月。比较两组抗血小板治疗3个月后的血小板聚集情况和1年内的不良心血管事件(MACE)发生情况。结果两组治疗后二磷酸腺苷诱导的血小板聚集率(PLADP)组间差异有统计学意义(P<0.05),而花生四烯酸诱导的血小板聚集率(PLAA)组间差异无统计学意义(P>0.05)。两组主要MACE发生率差异无统计学意义(P>0.05);而两组次要MACE发生率差异有统计学意义(P<0.05)。结论ACS患者介入治疗后早期应用双倍剂量氯吡格雷可以改善二磷酸腺苷代谢途径导致的氯吡格雷抵抗(CLR),而对花生四烯酸代谢途径的CLR无明显影响;此外,还可降低次要MACE发生率。
Objective To investigate the effect of double dose clopidogrel on patients with acute coronary syndrome(ACS).Methods From January 2015 to December 2018,320 patients with ACS treated by interventional therapy admitted to The Fourth Central Hospital of Tianjin were randomly divided into control group and observation group,160 cases each.In the control group,100 mg/d aspirin and 75 mg/d clopidogrel were used for antiplatelet therapy within 12 months after interventional therapy.In the observation group,aspirin 100 mg/d+clopidogrel 150 mg/d was used within 3 months after interventional therapy,and aspirin 100 mg/d+clopidogrel 75 mg/d was used for antiplatelet therapy for 9 months.The platelet aggregation and adverse cardiovascular events(MACE)within one year after antiplatelet therapy were compared between the two groups.Results There was a significant difference in adenosine diphosphate induced platelet aggregation rate(PLADP)between the two groups(P<0.05),but there was no significant difference in arachidonic acid induced platelet aggregation rate(PLAA)(P>0.05).There was no significant difference in the incidence of major MACE between the two groups(P>0.05),but there was significant difference in the incidence of secondary MACE between the two groups(P<0.05).Conclusion Double dose clopidogrel can improve clopidogrel resistance(CLR)induced by adenosine diphosphate metabolic pathway,but has no significant effect on the CLR of arachidonic acid metabolic pathway.In addition,it can reduce the incidence of secondary MACE.
作者
昝双江
ZAN Shuangjiang(The Fourth Central Hospital of Tianjin,Tianjin 300140,China)
出处
《中国实用乡村医生杂志》
2020年第8期56-58,61,共4页
Chinese Practical Journal of Rural Doctor
关键词
急性冠脉综合征
介入治疗
氯吡格雷抵抗
血小板凝聚
剂量
Acute Coronary Syndrome
Interventional Therapy
Clopidogrel Resistance
Platelet Aggregation
Dose
