【摘要】 目的观察冠脉支架术后联合应用阿司匹林和氯吡格雷的疗效及安全性。方法将行冠脉支架术的136例非ST段抬高的急性冠脉综合征患者随机分为试验组(70例)和对照组(66例)。试验组在冠脉支架术后长期联合应用(6～12个月,平均9个月)阿司匹林和氯吡格雷至随访结束;对照组在PCI术后联合应用阿司匹林和氯吡格雷1个月,以后长期应用阿司匹林。观察两组患者主要心血管事件(心血管性死亡、心肌梗死、心肌缺血复发进行靶血管再通治疗)及出血(严重出血、轻微出血)的发生率。结果试验组发生7例心血管事件(心肌梗死2例、靶血管再通治疗5例);对照组发生16例心血管事件(心血管性死亡1例,心肌梗死4例,靶血管再通治疗11例),两组间差异有显著性意义(P<0.05);两组均无严重出血,轻微出血率间差异无显著性意义(P>0.05)。结论冠脉支架术后长期联合应用阿司匹林和氯吡格雷安全、有效,可减少冠脉支架术后心血管事件的发生,出血并发症无明显增加。更多还原

【Abstract】 Objective To investigate the effect and safeness of combined application of aspirin and clopidogrel after percutaneous coronary intervention.Methods All 136 patients,received percutaneous coronary intervention (PCI) and with acute coronary syndrome of non-elevation of ST-segment,were at random divided as trial group (70 cases) and control group (66 cases).The patients in trial group were after PCI operation administered combination of aspirin and clopidogrel (6～12 months,average 9 months),up to the end of follow-up;the patients in trial group,after PCI operation,first received one month′s medication of combination of aspirin and clopidogrel,then singly aspirin for a long time.The occurrence rates of major cardiovascular events (cardiovascular death,myocardial infarction,re-building operation of blood flow for target vessel due to myocardial ischemia) and hemorrhagic events (serious and mild bleeding) were observed.Results There were 7 cases of cardiac events in trial group (2 cases of myocardial infarction,5 cases of re-building operation of blood flow for target vessel),and in control group there were 16 cases of cardiac events (1 case of cordial death,4 cases of myocardial infarction and 11 cases of re-building operation of blood flow for target vessel),there was a significant difference between the two groups (P<0.05).No serious hemorrhage occurred in both groups,and there was no significant difference in mild hemorrhagic event between the two groups (P>0.05).Conclusion A long period of administration of combined application of aspirin and clopidogrel after percutaneous coronary intervention was safe and effective.It could reduce the occurrence of cardiovascular events after PCI operation,with no obvious increase of hemorrhage complication.更多还原