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不同剂量氯吡格雷辅助治疗急性ST段抬高心肌梗死的量效关系及安全性 被引量:5

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摘要 目的探讨不同剂量氯吡格雷辅助治疗急性ST段抬高心肌梗死的量效关系及安全性。方法将86例急性ST段抬高心肌梗死(STEMI)患者随机分为2组:高剂量组43例,低剂量组43例。2组患者入院后均给予阿司匹林300 mg/d,共服用3 d,以后降为100 mg/d。住院期间同时给予镇痛、静脉溶栓、降脂及减轻心脏耗氧等常规治疗。溶栓开始前,高剂量组首剂给予氯吡格雷600 mg口服,低剂量组给予氯吡格雷300 mg口服,之后2组分别给予维持剂量75 mg/d。检测治疗后2组肌酸激酶同工酶(CK-MB)峰值和达峰时间,治疗前后血液流变学指标,统计治疗36 h及治疗36 d时主要不良心血管事件(MACE)以及治疗期间出血事件发生率。结果高剂量组CK-MB峰值显著低于低剂量组,达峰时间显著短于低剂量组(P<0.05)。治疗后2组各血液流变学指标均较治疗前明显下降,而治疗后高剂量组各指标均明显低于低剂量组(P<0.05)。高剂量组治疗36 h及治疗30 d后,MACE发生率均明显低于低剂量组(P<0.05)。高剂量组和低剂量组出血事件发生率比较无显著性差异(P>0.05)。结论与氯吡格雷300 mg相比,采用氯吡格雷600 mg作为起始剂量辅助治疗急性STEMI患者可更有效地改善患者血液流变学指标,恢复心肌功能,降低MACE发生率,且安全性较好。
作者 孙丽
机构地区 天津市海河医院
出处 《现代中西医结合杂志》 CAS 2013年第28期3134-3136,共3页 Modern Journal of Integrated Traditional Chinese and Western Medicine
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