目的 觀察氯吡格雷聯(lián)合阿司匹林治療急性冠脈綜合征患者的臨床療效。方法 回顧性納入2022年12月—2023年12月航天中心醫(yī)院接受PCI治療的220例急性冠脈綜合征患者，按照治療方法不同將患者分為對(duì)照組（阿司匹林單藥，n＝110）和治療組（阿司匹林＋氯吡格雷，n＝110）。PCI術(shù)后對(duì)照組服用阿司匹林腸溶片，100 mg/d；治療組服用阿司匹林腸溶片100 mg/d，硫酸氫氯吡格雷片75 mg/d。兩組用藥12個(gè)月，均電話隨訪或門診隨訪資料齊全。觀察兩組的臨床療效和主要不良心血管事件（MACE）發(fā)生率，比較兩組治療前后血小板功能、凝血指標(biāo)和左心室功能指標(biāo)。結(jié)果 治療組總有效率（94.55%）顯著高于對(duì)照組（83.64%）（P＜0.05）。治療后，兩組血小板聚集率、ADP誘導(dǎo)聚集、D-二聚體水平均顯著降低，而出血時(shí)間顯著延長(zhǎng)（P＜0.05）；治療后，治療組血小板聚集率、ADP誘導(dǎo)聚集、D-二聚體水平低于對(duì)照組，出血時(shí)間長(zhǎng)于對(duì)照組（P＜0.05）。治療后，兩組左室射血分?jǐn)?shù)（LVEF）顯著升高，左室收縮末期內(nèi)徑（LVESd）與舒張末期內(nèi)徑（LVEDd）顯著降低（P＜0.05）；治療后，治療組LVESd和LVEDd顯著低于對(duì)照組（P＜0.05）。治療過(guò)程中，治療組和對(duì)照組MACE發(fā)生率分別是10.91%、23.64%，兩組比較差異顯著（P＜0.05）。結(jié)論 針對(duì)PCI術(shù)后的急性冠脈綜合征患者，阿司匹林聯(lián)合氯吡格雷治療12個(gè)月，在提高臨床療效、降低MACE風(fēng)險(xiǎn)及抑制血小板活化方面顯著優(yōu)于阿司匹林單藥治療，且未增加嚴(yán)重安全性風(fēng)險(xiǎn)，整體獲益顯著。

Objective To observe the clinical efficacy of clopidogrel combined with aspirin in treatment of acute coronary syndrome. Methods A total of 220 patients with acute coronary syndrome who underwent PCI treatment at Aerospace Center Hospital from December 2022 to December 2023 were retrospectively included. The patients were divided into control group (aspirin monotherapy, n = 110) and treatment group (aspirin + clopidogrel, n = 110) according to different treatment methods. After PCI operation, patients in control group were given 100 mg of Aspirin Enteric-coated Tablet per day. Patients in treatment group were given Aspirin Enteric-coated Tablet at a dose of 100 mg/day and Clopidogrel Bisulfate Tablets at a dose of 75 mg/day. Both groups were treated with medication for 12 months, and the data of telephone follow-up or outpatient follow-up were complete. The clinical efficacy and the incidence of major adverse cardiovascular events (MACE) were observed, and the platelet function, coagulation indicators and left ventricular function indicators were compared before and after treatment in two groups. Results The total effective rate of treatment group (94.55%) was significantly higher than that of control group (83.64%) (P < 0.05). After treatment, the platelet aggregation rate, ADP-induced aggregation and D-dimer level in both groups were significantly decreased, but the bleeding time was significantly prolonged (P < 0.05). After treatment, the platelet aggregation rate, ADP-induced aggregation and D-dimer level in treatment group were lower than those in control group, and the bleeding time was longer than that in control group (P < 0.05). After treatment, LVEF in both groups significantly increased, but LVESd and LVEDd significantly decreased (P < 0.05). After treatment, the LVESd and LVEDd in treatment group were significantly lower than those in control group (P < 0.05). During the treatment process, the incidence of MACE in treatment group and control group was 10.91% and 23.64%, respectively, and there was a significant difference between two groups (P < 0.05). Conclusion For patients with acute coronary syndrome after PCI, the treatment of aspirin combined with clopidogrel for 12 months was significantly superior to aspirin monotherapy in improving clinical efficacy, reducing the risk of MACE and inhibiting platelet activation, without increasing the risk of serious safety, and the overall benefit was significant

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