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目的:观察急性冠脉综合征(ACS)患者经皮冠状动脉介入治疗(PCI)早期不同剂量阿司匹林、氯吡格雷对主要不良心血管事件(MACE)的影响。方法:选择2007年12月～2009年12月ACS行PCI术的患者102例,所有患者按入院先后随机分为两组,1组为加量组(n=54),患者入院后阿司匹林300 mg顿服,然后300 mg,每日1次,口服1个月后改为100 mg,每日1次,长期口服;氯吡格雷150 mg,每日1次,1周后改为75 mg,每日1次,口服1年。另1组为对照组(n=48),患者入院后阿司匹林100 mg,每日1次,以后长期按此剂量口服。氯吡格雷75 mg,每日1次,口服1年。两组患者其他治疗低分子肝素等方法相同。分别于PCI术后1个月、6个月时比较MACE的发生情况。结果:两组患者临床基线特征基本一致,病变血管分布情况差异无统计学意义。其MACE发生情况在第一个月时,加量组低于对照组,但差异未到达显著水平(7%vs.15%);在第6个月时,加量组低于对照组,差异具有统计学意义(2%vs.17%,P<0.05)。结论:ACS患者在一般治疗的基础上,介入治疗时早期增加阿司匹林、氯吡格雷的剂量可降低PCI术后MACE的发生率。
Objective: To observe the effect of different doses of aspirin and clopidogrel on major adverse cardiovascular events (MACE) in patients with acute coronary syndrome (ACS) at the early stage of percutaneous coronary intervention (PCI). Methods: A total of 102 patients undergoing PCI from December 2007 to December 2009 were enrolled in this study. All patients were randomly divided into two groups according to hospital admission. One group was added dose group (n = 54), and aspirin 300 mg Dayton clothing, and then 300 mg, 1 day, 100 mg orally after 1, once daily, long-term oral; clopidogrel 150 mg once daily, 1 week to 75 mg, Day 1, oral for 1 year. The other group was control group (n = 48). Patients were given aspirin 100 mg once daily after oral administration. Clopidogrel 75 mg, once daily, orally for 1 year. The other two groups of patients with other methods of treatment of low molecular weight heparin and the same. The occurrence of MACE was compared at 1 month and 6 months after PCI respectively. Results: The baseline characteristics of the two groups of patients were basically the same, and there was no significant difference in the distribution of vascular lesions. The incidence of MACE was lower in the first month than in the control group, but the difference did not reach a significant level (7% vs.15%); at the sixth month, the dosage group was lower than the control group, and the difference Statistically significant (2% vs.17%, P <0.05). Conclusions: On the basis of general treatment, ACS patients initially receive aspirin or clopidogrel at the early interventional interval to reduce the incidence of MACE after PCI.