论文部分内容阅读
一部分ST段抬高型心肌梗死(STEMI)病人接受溶栓疗法后存在梗死相关血管的不完全再通,并导致并发症和死亡的危险性增加.对于已接受溶栓和阿司匹林治疗的STEMI病人加用氯吡格雷是否有益这一关键问题尚无定论. 方法此研究纳入了3491例心电图有STEMI病人;平均年龄在(18～75)岁.入选标准:12h之内有静息下的心绞痛至少持续20min;ST段抬高在至少两个相邻肢导≥0.1mV,在至少两个相邻胸导≥0.2mV,并且以往无左束支传导阻滞.所有病人按常规接受溶栓及阿司匹林治疗.病人被随机分为两组,一组接受安慰剂,一组接受氯吡格雷(75mg/d).病人接受治疗2～8天时,行冠脉造影检查.研究的主要终点包括冠脉造影时梗死相关动脉通畅情况(TIMI分级0～1级)、冠脉造影前心肌梗死复发或死亡.
Some patients with ST-elevation myocardial infarction (STEMI) have an incomplete recanalization of infarct-related blood vessels after thrombolytic therapy and may increase the risk of complications and death.For STEMI patients who have received thrombolysis and aspirin therapy The key issue of whether clopidogrel is beneficial is inconclusive. METHODS: This study enrolled 3491 patients with STEMI on electrocardiogram (mean age 18-75 years). Criteria for inclusion: Resting angina within 12 hours at least sustained 20 min, ST segment elevation ≥0.1 mV in at least two adjacent limbs, ≥0.2 mV in at least two adjacent thoracic tubes, and no previous history of left bundle branch block.All patients underwent routine thrombolysis and aspirin therapy Patients were randomized into two groups, one receiving placebo and the other receiving clopidogrel (75 mg / d), and patients undergoing coronary angiography at 2-8 days of treatment.The primary end points included coronary angiography Infarct-related artery patency (TIMI grade 0 to 1), myocardial infarction before coronary angiography recurrence or death.