文章摘要
王渊铭陈德黄晴王蕊姚建华.不同剂量氯吡格雷治疗急性ST 段抬高心肌梗死的疗效及安全性分析[J].,2012,12(18):3505-3507
不同剂量氯吡格雷治疗急性ST 段抬高心肌梗死的疗效及安全性分析
Effectiveness and Safety of Different Doses of Clopidogrel in Patients withAcute ST-segment Elevation Myocardial Infarction
  
DOI:
中文关键词: 氯吡格雷  急性ST 段抬高心肌梗死  剂量
英文关键词: Clopidogrel  Acute ST-segment elevation myocardial infarction  Dose
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作者单位
王渊铭陈德黄晴王蕊姚建华 同济大学附属上海市杨浦区中心医院心内科 
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中文摘要:
      目的:探讨不同剂量氯吡格雷治疗急性ST 段抬高心肌梗死(STEMI)的疗效及安全性。方法:178 例急性STEMI 患者随机分 为高剂量组和常规剂量组,每组各69 例。两组均给予阿司匹林、静脉溶栓、抗凝及降脂等常规治疗,高剂量组和常规剂量组分别 口服氯吡格雷负荷量600 mg、300 mg,之后两组患者给予维持量75 mg/d。结果:治疗30 d 后,高剂量组总有效率为91.0%,常规 剂量组为77.5%,差异有统计学意义(P<0.05);高剂量组治疗后36 h 及30d 的MACE 发生率为3.4%和6.7%,常规剂量组为12.4% 和18.0%,差异均有统计学意义(P<0.05);两组出血发生率分别为9.0%,5.6%,差异无统计学意义(P>0.05)。结论:高剂量(600 mg) 氯吡格雷治疗急性STEMI 疗效优于常规剂量(300 mg),且具有良好的安全性。
英文摘要:
      Objective: To explore the clinical effect and safety of different doses of clopidogrel on the treatment of acute ST-segment elevation myocardial infarction (STEMI). Methods:178 patients with acute STEMI were randomly divided into two groups. All the cases were given aspirin, intravenous thrombolysis, anticoagulants, lipid-lowering and so on. The patients respectively received 600 mg (high dose group, n=89) and 300 mg (normal dose group, n=89) loading dose of clopidogrel administration, followed by the maintenance dose of 75 mg/d. Result: The total effect rate of high dose group and normal dose group were 91.0% and 77.5% , the difference was statistically significant (P<0.05). The MACE rates within 24 hours(3.4% vs.12.4%)and 30 days(6.7% vs.18.0%) in high dose group were significantly lower than those in normal dose group (P<0.05). The rate of bleeding in high dose and normal dose group was 9.0% and 5.6%, respectively, with no significantly difference (P>0.05). Conclusions: High dose treatment of clopidogrel (600 mg) is better than normal dose treatment (300 mg) in acute STEMI and both methods have good safety.
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