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[摘要]
目的 探討阿司匹林聯(lián)合氯吡格雷對急性心肌梗死急診經(jīng)皮冠脈介入治療(PCI)術(shù)后心功能的影響。方法 選擇2014年10月-2016年10月,在新疆阿克蘇地區(qū)第一人民醫(yī)院急診科收治的142例急性心肌梗死患者為研究對象,均行PCI術(shù)治療;根據(jù)藥物治療方法的不同分為對照組(n=71)和聯(lián)合組(n=71);對照組術(shù)前術(shù)后在常規(guī)治療的基礎(chǔ)上給予氯吡格雷;聯(lián)合組在對照組治療的基礎(chǔ)上給予阿司匹林輔助治療。持續(xù)治療12個(gè)月。比較兩組的臨床效果,兩組術(shù)后心功能指標(biāo)及高敏C蛋白含量變化。結(jié)果 兩組術(shù)后冠脈造影在梗死部位均無血栓影,同時(shí)兩組1個(gè)月內(nèi)的治療總有效率分別為90.14%和81.69%,相比差異無統(tǒng)計(jì)學(xué)意義。兩組術(shù)后12個(gè)月再血栓發(fā)生率分別為1.41%和12.68%,聯(lián)合組明顯低于對照組,差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。聯(lián)合組治療后患者心功能明顯優(yōu)于對照組,差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。兩組在治療后24 h、72 h、7 d血清hs-CRP含量顯著低于治療前,同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05);聯(lián)合組在治療后24 h、72 h、7 d血清hs-CRP含量顯著低于對照組,差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。結(jié)論 阿司匹林聯(lián)合氯吡格雷可有效減少PCI術(shù)后再血栓的發(fā)生,改善急性術(shù)后心功能的恢復(fù),降低機(jī)體炎性免疫反應(yīng)。
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[Abstract]
Objective To investigate the Effect of Aspirin combined with clopidogrel on Cardiac function of Acute Myocardial Infarction after Emergency Percutaneous coronary intervention. Methods From October 2014 to October 2016, 142 patients with acute myocardial infarction were treated in the emergency department of our hospital were considered as objects. According to the treatment methods, all patients were divided into control group (n=71) and combined group (n=71); the control group underwent Clopidogrel on the basis of routine treatment, at preoperative and postoperative. The combined group were given Aspirin adjuvant therapy on the basis of control group. The clinical effect and adverse reaction after medication were compared between the two groups. The changes of cardiac function index and high sensitive c protein content in the two groups after operation were compared. Results There was no thrombus in the infarct site in the two groups after the operation. The total effective rate of control group and combined group were respectively 90.14% and 81.69 at first month. There was no significant difference between the two groups. In two groups after operation 12 months, the incidence rate of thrombosis were 1.41% and 12.68%, the combined group was significantly lower than the control group (P<0.05). The cardiac function of the combined group after treatment was better than the control group (P<0.05). After treatment 24 h, 72 h and 7 d, the serum hs-CRP content in the combined group was significantly lower than the control group (P<0.05). Conclusion Aspirin combined with clopidogrel can effectively reduce the occurrence of re-thrombosis after PCI, improve the recovery of cardiac function, and reduce the inflammatory immune response.
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