硫酸氫氯吡格雷片聯(lián)合阿司匹林治療急性心肌梗死的臨床療效及安全性觀察

　　[摘要] 目的 探討急性心肌梗死患者采取硫酸氫氯吡格雷片結合阿司匹林治療的應用價值。方法 選擇2013年6月～2017年6月我院收治的64例急性心肌梗死患者作為研究對象，按照隨機數(shù)字法分為研究組與對照組各32例。研究組采取硫酸氫氯吡格雷片結合阿司匹林，對照組僅采取阿司匹林治療，比較兩組患者臨床效果。結果 研究組總有效率為93.75%，明顯高于對照組的81.25%（χ2=7.143，P<0.05）；兩組患者血管再通率無明顯差異（χ2=0.198，P>0.05），但研究組再閉塞率較對照組降低（χ2=5.924，P<0.05）；且頭痛、腸胃不適及肌痛等不良反應發(fā)生率均較對照組低（χ2=9.191，7.143，13.333，P<0.05）；治療后兩組患者凝血酶原時間（PT）、部分活化凝血酶原時間（APTT）及血小板計數(shù)（Plt）水平無明顯差異（t=1.141，-0.234，-1.176，P>0.05），但與治療前相比明顯改善；研究組治療后左室射血分數(shù)（LVEF）水平較對照組提高，差異有統(tǒng)計學意義（t=9.791，P<0.05）。結論 急性心肌梗死患者采取硫酸氫氯吡格雷片結合阿司匹林治療效果顯著，緩解患者相關癥狀，明顯減少血管再閉塞情況，對患者凝血功能影響較小，安全性較高，具有推廣及應用的價值。
　　[關鍵詞] 硫酸氫氯吡格雷片；急性心肌梗死；阿司匹林
　　[中圖分類號] R541.4 [文獻標識碼] B [文章編號] 1673-9701（2018）08-0098-03
　　Clinical efficacy and safety of clopidogrel hydrogen sulfate tablets combined with aspirin in the treatment of acute myocardial infarction
　　ZHANG Xiao LI Weihua
　　Department of Emergency Internal Medicine，Shandong Academy of Medical Sciences Affiliated Hospital，Ji"nan 250031，China
　　[Abstract] Objective To investigate the clinical value of aspirin in patients with acute myocardial infarction（AMI）treated with clopidogrel bisulfate tablets. Methods 64 patients with acute myocardial infarction admitted in our hospital from June 2013 to June 2017 were divided into study group（n=32）and control group（n=32）， according to random number method. The study group was treated with clopidogrel bisulfate tablets combined with aspirin， and the control group was given aspirin treatment only. The treatment effect between two groups was compared. Results The total effective rate was 93.75% in the study group， which was significantly higher than 81.25% in the control group（χ2=7.143， P<0.05）. There were no significant differences in the revascularization rate between the two groups（χ2=0.198，P>0.05）. However， the re-occlusion rate of the study group was lower than that of the control group（χ2=5.924， P<0.05）. The incidence of adverse reactions such as headache， gastrointestinal upset and myalgia was lower than that in the control group（χ2=9.191，7.143，13.333，P<0.05）. There were no significant differences in the prothrombin time（PT）， partial prothrombin time（APTT）and platelet count（Plt）between the two groups after treatment（t=1.141， -0.234， 1.176， P>0.05）. But the indicators significantly improved compared with those before treatment. The LVEF level of the study group was significantly higher than that of the control group after treatment（t=9.791，P<0.05）. Conclusions The treatment of clopidogrel hydrogen sulfate tablets combined with aspirin in patients with acute myocardial infarction has a significant therapeutic effect， which can alleviate the symptoms and reduce the reocclusion of the patients. It has less influence on the coagulation function and higher safety， and has great value in popularization and application.

相關熱詞搜索：心肌梗死 阿司匹林 硫酸 療效 格雷