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1、氯毗格雷治疗急性心肌梗死临床观察［摘要］目的：探讨氯毗格雷治疗急性心肌梗死(AMI)的有效性和安全性。方法：选择符合溶栓治疗适应证、无溶栓治疗禁忌证发病12h以内的急性心肌梗死患者107例，将其分为观察组和对照组。对照组44例，给予肠溶阿司匹林片口服，尿激酶静脉溶栓治疗，溶栓12h后皮下注射低分子肝素钙；观察组63例，在对照组治疗基础上加用氯毗格雷负荷量300mg,以后75mg/do对两组间血管再通率、冠状动脉内血栓形成率和治疗后心肌梗死再发率、出血率、病死率及梗死后心绞痛发生率等进行比较分析。结果：患者经治疗后心绞痛发生率、再发心肌梗死率、血管再通率、冠
2、脉内血栓形成率观察组显著低于对照组，差异有统计学意义(P<0.05),心力衰竭率、出血率、脑梗死发生率、死亡率观察组与对照组相比差异无统计学意义(P>0.05)o结论：氯毗格雷治疗急性心肌梗死是安全有效的。［关键词］氯毗格雷；心肌梗死；临床观察［中图分类号］R541［文献标识码］B［文章编号］1673-7210(2011)07(c)-146-02ClinicalobservationontreatmentofacutemyocardialinfarctionbyClopidogrelHUANGZhutong,PANXuesong,HANFuhaiTheFi
3、rstPeople"sHospitalofFangchenggangCityinGuangxiZhuangAutonomousRegion,Fangchenggang538001,China[Abstract]Objective：Toevaluatetheeffectivenessandsafetyofthetreatmentofacutemyocardialinfarction(AMI)withclopidogreLMethods：107patients(68malesand39females,withAMIwithin12hours)withoutco
4、ntraindicationforthrombolytictherapyweredividedintotwogroups：observationgroup(n=44)andcontrolgroup(n=63)・ThepatientsoftwogroupsallacceptedentericoralAspirin,intravenousthrombolytictherap・withUrokinaseandsubcutaneousinjectionwith1ow-mo1ecu1ar~weightheparincalciumafterthrombolyticth
5、erapy12hlater,andtheobservationgroupadded300mgClopidogreland75mgoncedailyafterthefirstday.Thera/teofpatencyofinfarct-relatedanery(IRA),intracoronarythrombus,re-infarctionaftertherapy,hemorrhagiccomplications,mortalityandpost-infarctionanginawerecomparedandanalyzedbetweenthetwogrou
6、ps・Results：Therateofangina,re-infarction,patencyofinfarct—relatedanery(IRA)andintracoronarythrombusinobservationgroupwereobviouslylowerthanthoseincontrolgroup(P<0.05).Therewasnosignificantdifferenceintherateofheartfailure,hemorrhagiccomplications,cerebralinfarction,andmortalityinb
7、othgroups(P>0.05).Conclusion：Thetreatmentofacutemyocardialinfarctionwithclopidogrelissafeandeffective..Keywords]Clopidogrel；Myocardialinfarction；Clinicalobservation急性心肌梗死(AMI)发病急骤、凶险，发病24h内病死率较高，已成为发达国家和发展中国家人口死亡的最常见原因之一，并成为严重的公共卫生问题。其发生的主要的病理生理机制是动脉粥样硬化斑块破裂，凝血系统被激活而形成血栓。及早行溶栓治疗，恢
8、复梗死区缺血心肌再灌注，能有效地保护心功能和降低病死率，已成为AM
