阿司匹林联合氯吡格雷治疗急性心肌梗死的效果论文

-本文为网络收集精选范文、公文、论文、和其他应用文档，如需本文，请下载-阿司匹林联合氯吡格雷治疗急性心肌梗死的效果论文本文从网络收集而来，上传到平台为了帮到更多的人，如果您需要使用本文档，请点击下载按钮下载本文档（有偿下载），另外祝您生活愉快，工作顺利，万事如意！中图分类号 文献标识码 A 文章编号 1674-4721（2019）2（a）-0073-04Abstract Objective To investigate the effect of Aspirin combined with Clopidogrel in the treatment of acute myocardial infarction. Methods From February 2014 to August 2017， a total of 88 patients with acute myocardial infarction admitted to our hospital were selected as research objects and they were divided into the observation group （44 cases） and the control group （44 cases） according to different treatment methods. In the control group， Aspirin alone was used， while in the observation group， Clopidogrel was added on the basis of the control group. The coagulation function indicators （activated partial prothrombin time APTT， prothrombin time PT， platelet PLT） and cardiac function indicators （left ventricular ejection fraction LVEF， left ventricle end systolic diameter LVESD）， left ventricular end diastolic diameter LVEDD） before and after treatment and incidence of cardiovascular events between the two groups were compared. Results There were no significant differences in coagulation function indicators between the two groups before treatment （P）. The APTT and PT after treatment in the two groups were longer than those before treatment， the PLT was lower than that before treatment， and the differences were statistically significant （P）. There were no significant differences in cardiac function indicators between the two groups before treatment （P）. The LVEF after treatment of the observation group was higher than that before treatment， the LVESD and LVEDD were lower than those before treatment， and the differences were statistically significant （P）. The LVEF after treatment in the observation group was higher than that in the control group， the LVESD and LVEDD were lower than those in the control group， and the differences were statistically significant （P），具有可比性。所有患者均知情同意本研究并签署知情同意书，本研究已经我院医学伦理委员会批准。方法对照组患者单独采用阿司匹林（哈药集团制药总厂，生产批号：23021186）治疗，嘱咐患者保持卧床休息，采用硝酸酯类、他汀降脂类与-受体阻滞剂等药物对患者进行治疗;对患者行溶栓治疗，患者口服阿司匹林，首次服用剂量为300 mg，每天服用1次，用药3 d后，改为每次服用100 mg，每天服用1次，连续治疗1个月。观察组患者在对照组的基础上加用氯吡格雷（深圳信立泰药业股份有限公司，生产批号：H20000542）治疗，患者口服氯吡格雷，首次服用剂量为300 mg，服用2 d后改为每次75 mg，每天服用1次，连续服用1个月。观察指标比较两组患者治疗前后的凝血功能指标活化部分凝血酶原时间（APTT）、凝血酶原时间（PT）、血小板（PLT）及心功能指标左室射血分数（LVEF）、左室收缩末内径（LVESD）、左室舒张末内径（LVEDD）变化情况，并比较两组患者的心血管事件发生情况。采用手工法测定两组患者的APTT，采用血液凝固仪测定PT，采用全自动血型仪测定PLT。两组患者均行超声心电图以检查LVEF、LVESD及LVEDD。心血管事件包括复合终点、死亡、梗死后心绞痛、再发心肌梗死。统计学方法采用SPSS 统计学软件进行数据分析，计量资料用均数标准差（xs）表示，两组间比较采用t检验;计数资料采用率表示，组间比较采用2检验，以P）;两组患者治疗后的APTT、PT均长于治疗前，PLT低于治疗前，差异有统计学意义（P）（表1）。两组患者治疗前后心功能指标的比较两组患者治疗前的心功能指标比较，差异无统计学意义（P）;观察组患者治疗后的LVEF高于治疗前，LVESD、LVEDD低于治疗前，差异有统计学意义（P）;观察组患者治疗后的LVEF高于对照组，LVESD、LVEDD低于对照组，差异有统计学意义（P）;两组患者治疗后的APTT、PT均长于治疗前，PLT低于治疗前，差异有统计学意义（P），提示氯吡格雷不会增加出血风险。两组患者治疗前的心功能指标比较，差异无统计学意义（P）;观察组患者治疗后的LVEF高于治疗前，LVESD、LVEDD低于治疗前，差异有统计学意义（P）;观察组患者治疗后的LVEF高于对照组，LVESD、LVEDD低于对照组，差异有统计学意义（P）。观察组患者的复合终点、死亡、梗死后心绞痛、再发心肌梗死发生率均低于对照组，差异有统计学意义（P）。提示阿司匹林联合氯吡格雷治疗能降低不良心血管事件发生率，改善患者心功能，其主要得益于两药之间