氯吡格雷对冠心病患者临床预后与血小板功能影响的临床.研究

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1、军医进修学院硕士学位论文ClinicalstudyoftheeffectsofclopidogrelonclinicalprognosisandplateletfunctioninpatientswithcoronaryheartdiseaseABSTRACTBackgroundandObjectiveInrecentyears，antiplatelettherapyinpatientswithacutecoronarysyndromes(ACS)becomesmoreandmoreimportant．Clopidogrelisanewthienopyrid

2、inederivativewhichhasbeenshowntoI．educemorbidityandmortalityinACS，especiallyafterpercutaneouscoronaryinterventions(PCI)．Ithasbeendemonstratedthattheprognosisinpatientswhoacceptedaspirinandclopidogrelisbetter．Atpresent，thetreatmentcourseofclopidogrelisabout1year．However,sometrialssu

3、ggestlong-term(>1year)clopidogreltherapymayachieveextrabetterprognosisforACS．Toinvestigatewhetherlong-termdualantiplatelet(aspirinandclopidogrel)treatmentisassociatedwithbetterprognosisforACS，weattemptedtoretrospectivelyevaluatetheefficacyandsafetyofthelong-termdualantiplateletregi

4、men．Moreover,inordertoprovideexperimentalevidenceforclinicalapplicationofdualantiplateletregimen，weanalyzedtheeffectsofclopidogrelonplateletfunctioninelderlypatientswithcoronaryheartdisease(CHD)．MethodsFromJune2005toJune2006，atotalof338hospitalizedpatientswithACSwereenrolledin0111"

5、hospital．Theywereassignedtoaspiringroup(group1，administerdasprinasasingleantiplatelettherapyregimenafterdischarge，n=93)，dualantiplatelettreatment1yeargroup(group2，administerdasprinandclopidogrelasadualantiplatelettherapyregimenafterdischargefor6to12months，thenkeeponadministeringasp

6、rin，n=127)anddualantiplatelettreatment2yeargroup(group3，administerdasprinandclopidogrelasadualantiplatelettherapyregimenafterdischargefor2years，n=l18)．Thefollow．upperiodforallthepatientsWas2years．ItWasretrospectivelyanalyzedandcomparedbetweentheminclinicaldata(basicclinicaldata，dru

7、gtreatmentdata，7军医进修学院硕士学位论文plateletcount，coagulationindexesandserumlipidsindexes)，primaryendpoint(cardiovasculardeath，nonfatalmyocardialinfarctionandstroke)andhemorrhagicevents(majorhemorrhage，moderatehemorrhageandminorhemorrhage)within1and2years．FromJanuaryof2007toJuneof2007，32ho

8、spitalizedpatientsofCHDwer