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目的分析经皮冠状动脉介入术(PCI)前应用不同剂量氯吡格雷的临床效果及安全性。方法选取择期行PCI术患者78例,按照双盲法随机分为观察组和对照组各39例,观察组患者进行PCI术前服用氯吡格雷450mg,对照组患者进行PCI术前服用氯吡格雷300mg,比较2组患者血小板活化指标、血栓最大幅度(MA)、血小板抑制率、血小板聚集率及近远期不良事件发生率等。结果观察组患者CD62P、CD63及TSP等各项血小板活化指标均明显低于对照组,差异有统计学意义(P<0.01)。治疗后2组患者血小板聚集率、MAADP指标明显低于治疗前,血小板抑制率明显高于治疗前,差异均有统计学意义(P<0.05)。观察组以上指标改善情况优于对照组,差异有统计学意义(P<0.05)。观察组患者治疗后1、6个月不良反应总发生率均低于对照组,差异有统计学意义(P<0.05)。结论PCI术前采用450mg高剂量氯吡格雷治疗相对于300mg常规剂量氯吡格雷治疗的临床效果更显著,且不良反应发生率低,是一种安全、有效的治疗方案,值得推广应用。
Objective To analyze the clinical effect and safety of different doses of clopidogrel before percutaneous coronary intervention (PCI). Methods Seventy-eight patients undergoing elective PCI were randomly divided into observation group (39 cases) and control group (39 cases). Patients in the observation group were given clopidogrel 450 mg before PCI, and patients in the control group received clopidogrel 300mg. The indexes of platelet activation, maximal thrombus (MA), platelet inhibition rate, platelet aggregation rate and the incidence of short-term and adverse events in two groups were compared. Results The indexes of platelet activation such as CD62P, CD63 and TSP in observation group were significantly lower than those in control group (P <0.01). After treatment, the platelet aggregation rate and MAADP index of two groups were significantly lower than those before treatment, the inhibition rate of platelet was significantly higher than that before treatment, the difference was statistically significant (P <0.05). The improvement of the above indexes in the observation group was better than that in the control group, the difference was statistically significant (P <0.05). The total incidence of adverse reactions in observation group was lower than that in control group at 1 and 6 months after treatment, the difference was statistically significant (P <0.05). Conclusion The clinical efficacy of high dose clopidogrel 450 mg before PCI is more significant than that of conventional clopidogrel 300 mg, and the incidence of adverse reactions is low. It is a safe and effective treatment and is worth popularizing.