氯毗格雷对非ST段抬高心肌梗死患者急诊冠脉介入治疗的作用朱秀龙，张灿，孙喜文，陈炎，黄猱(高州市人民医院心血管内科，广东高州525200)摘要；目的观察氯毗格宙应用于非ST段抬高心肌槌死患者急诊介入治疗的作用。方法选择诊断为非ST段抬高心肌梗死患者112例，随机分为对■照组和实验组，每组各56例，均实行相同的标准治疗，病例均急诊行冠脉造影及冠脉介入治疗(PCI),实验组除标准治疗外，入院即刻给予氯毗格曲对照组给予睦氯I兀定。2组均随访半年。结果实验组PCI术后实验组患者的TIMI3级血流获得数为91.1%,较对照组高(87.5%),2组间差异无统计学意义(/>0.05)。另外，2组在心功能分级、威胁生命出血方面亦无统计学差异(/>()・()5)。实骏组轻度出血明显少于対照组(PV0.05),实验组血小板降低程度、白细胞总数均明显低于对照组(K0.05)；半年的随访中，实验组联合终点与对照组比较差异有统计学意义(X0.05).结论氯毗格雷对非ST段抬高心肌梗死患者急诊介入治疗有良好的效果，能降低急诊介入治疗的心血管事件风险。关键词：心肌梗死；氯毗格雷；冠脉介入治疗中图法分类号：文献标识码£AValueofclopidogrelinemergencycoronainterventionaltherapyformyocardialinfarctionpatientswithnon-STsegmentelevation:reportof112casesZHUXiu-long,ZHANGCamSUNXi-wcn,CHENYan,HUANGMeng(DepartmentofCardiology.GaozhouPeople'sHospitalGaozhou52500、GuangdongProvince,China)Abstract：ObjectiveToobservetheefficiencyofclopidogrelcombinedwithemergencycoronainterventionaltherapyfornon-STsegmentelevationmyocardialinfarction.MethodsAtotalof112patientswithnon-STsegmentelevationmyocardialinfarctionwhowereadmittedinourhospitalfromFebruary2004toNovember2007wereequallydividedinto2groupsatrandomwith56patientsineach,theexperimentalgroupandthecontrolgroup・Allpatientsweretreatedwithemergencycoronainterventionaltherapyandtheotherroutinestandardtherapies.Theexperimentalgroupwastreatedwithclopidogrel(75mg,onceperdayfor8weeks),andthecontrolgroupadministeredticlopidine(250mg,twiceperdayfor8weeks).Thetwogroupwerefollowedupforatimeofhalfayear.ResultsTheTIMI(thrombolysisinmyocardialinfarction)myocardial-perfusiongrade3angiographicflowwasachievedin91.1%ofthecxpcrimcnUilgroup,higherthanthatofthecontrolgroup(87.5%),buttherewasnosignificantdifferencebetweenthem・What'smore,therewasnoobviousdifferencebetweenthe2groupincardiacfunctionalgnidingandlife-threateningbleeding.Theexperimentalgrouphadsignificantlylesserhyporrhea,andlowerplateletdegradationandtotalwhitebloodcellscountsincomparisontothecontrolgroup・Afterthefollowcd-upofhalfayear,therewassignificantdifferencebetweenthemincombination-cndpoint・ConclusionAdditionofclopidogreliseffectiveinemergencycoronainterventionaltherapyfornon-STsegmentelevationmyocardialinfarction,whichcandegradetheriskofemergencycoronainterventionaltherapy.Keywords：myocardialinfarction;clopidogrel;emergencycoronainterventionaltherapy急性非ST段抬高心肌梗死属于冠心病的严重类型，发病急骤、凶险、病死率高，容易被忽视，激活凝血系统形成血栓是其重耍病理生理机制"⑵。非ST段抬高心肌梗死的血栓形成以富含血小板的白血栓或灰血栓为主，不宜溶栓治疗，但其病死率和心肌梗死发生率高。因血小板及凝血因子的激活是其血栓形成的机制，抗血小板药物是其治疗措施之一。本研究旨在探讨急诊冠脉介入手术联合氯毗格雷治疗急性非ST段抬高心肌梗死患者近期的疗效及安全效果。1资料与方法1.1研究对象选择2004年2月至2007年11月入住我院的112例诊断为非ST段抬高心肌梗死的患者，其中男性72例，女性40例，年龄56〜74(61.2+8.3)岁，全部患者符合2002年ACC/AIIA诊断标准。随机均分为实验组和对照组，每组各56例，2组在年龄.性别、心率、血压、心肌械死部位、血脂、心功能...