高维持量氯吡格雷对急性前壁心肌梗死行择期经皮冠脉介入治疗患者的左心室功能及安全性影响.docVIP

精品论文 参考文献 高维持量氯吡格雷对急性前壁心肌梗死行择期经皮冠脉介入治疗患者的左心室功能及安全性影响 王聪 周小波 寇双庆 渠慎成 刘超 李鹏盈 于莹 刘钰 　　（天津市东丽区东丽医院心内科 300300） 　　【摘要】目的：探讨择期PCI治疗应用氯吡格雷150mg/日高维持量对急性前壁心肌梗死患者的疗性及安全性。方法：选择急性前壁心肌梗死并行择期经皮冠脉介入治疗患者52例随机分为氯吡格雷75mg/日对照组高剂量氯吡格雷150mg/日试验组。多次测定患者的BNP指标、血小板聚集率并评价PCI术中TIMI血流和TPMG水平及PCI术前、术后一个月、六个月核素心血池显像检查各指标变化。结果：1. 试验组较对照组的校正TIMI计帧数有减少的趋势，但无统计学差异（Pgt;0.05）。TMPG水平试验组优于对照组（Plt;0.05）。2. 试验组和对照组的血小板聚集率水平入院时无明显差异（Pgt;0.05），术前、术后一个月、六个月两组间均有明显差异（P值均lt;0.05）。3. 心功能指标，两组间有明显差异（Plt;0.05）。4. 主要心血管不良事件和出血情况的对比，两组无统计学差异（P gt;0.05）。结论：高维持量氯吡格雷可以一定程度上改善急性前壁心肌梗死患者PCI术中冠脉血流和心肌灌注水平。可以更加有效的抑制血小板聚集，显著减少PCI术后急性和亚急性支架内血栓事件发生率，有益影响呈滞后性。 　　【关键词】高维持量氯吡格雷 急性前壁心肌梗死 心功能 心肌灌注 择期PCI 　　【中图分类号】R969 【文献标识码】A 【文章编号】2095-1752（2014）13-0012-03 　　Left ventricular function effect and Safety of high maintenance dose of clopidogrel in patients with acute anterior myocardial infarction undergoing selective PCI 　　【ABSTRACT】Objective: To assess the beneficial efficacy and safety of the high maintenance dose of clopidogrel in acute anterior myocardial infarction（AMI）patients undergoing selective percutaneous coronary intervention (PCI).Methods: Totally 52 patients who had been diagnosed as acute anterior myocardial infarction and prepared to selective percutaneous coronary intervention (PCI) treatment were randomly divided into two groups: the control group (75mg clopidogrel per day) and the high maintenance dose group (150mg clopidogrel per day) . Record the information of patients in-hospital , in the 1 month and 6 months including the level of BNP,LPER,LPFR,LTPER,LTPFR.Result: The CTFC of the Test group after PCI was smaller than the standard dose group (Pgt;0.05). The level of TMPG was better in the test group (Plt;0.05). The primary platelet aggregation rate was significant difference after 1 month and 6 months (Plt;0.05).The LPER,LPFR 6 months after PCI in the high maintenance dose group is higher than the control group (Plt;0.05), but there was no si