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目的探讨急性冠脉综合征(ACS)患者血浆纤维蛋白原(Fib)、D-二聚体水平变化,及氯吡格雷的干预治疗作用。方法选择健康成人40例,冠心病患者125例,其中80例急性冠脉综合征(ACS)患者(急性心肌梗死(AMI)32例、不稳定型心绞痛(UA)48例)和稳定性心绞痛(SA)患者45例,ACS患者随机分成氯吡格雷组(40例);常规治疗组(40例),分别检测血浆Fib、D-二聚体水平变化。结果 UA、AMI、ACS组血浆Fib及D-二聚体水平明显高于SA组及正常对照组,差异有统计学意义(P<0.01);AMI组血浆Fib及D-二聚体水平明显高于UA组,差异有统计学意义(P<0.05,P<0.01);氯吡格雷组和常规治疗组治疗后Fib及D-二聚体水平均显著下降(P<0.05,P<0.01),且氯吡格雷组下降水平优于常规治疗组(P<0.05)。结论血浆Fib及D-二聚体指标水平高低与ACS严重程度密切相关,氯吡格雷可以有效降低血浆Fib及D-二聚体指标水平,抑制血栓形成,稳定斑块。
Objective To investigate the changes of plasma fibrinogen (Fib) and D-dimer in patients with acute coronary syndrome (ACS) and the therapeutic effect of clopidogrel. Methods Forty healthy adults and 125 patients with coronary heart disease were enrolled. Methods Eighty patients with acute coronary syndrome (ACS) (32 with acute myocardial infarction (AMI), 48 with unstable angina (UA)) and stable angina SA) were randomly divided into clopidogrel group (n = 40) and routine treatment group (n = 40). The levels of Fib and D-dimer in plasma were detected respectively. Results The levels of plasma Fib and D-dimer in UA, AMI and ACS groups were significantly higher than those in SA group and normal control group (P <0.01). The levels of Fib and D-dimer in AMI group were significantly higher (P <0.05, P <0.01). The levels of Fib and D-dimer in the clopidogrel group and the conventional treatment group were significantly decreased (P <0.05, P <0.01) in the UA group, And clopidogrel group decreased better than the conventional treatment group (P <0.05). Conclusion The levels of Fib and D-dimer in plasma are closely related to the severity of ACS. Clopidogrel can effectively reduce the levels of Fib and D-dimer in plasma, inhibit thrombosis and stabilize the plaque.