目的 观察氯吡格雷联合阿司匹林治疗急性冠脉综合征患者的临床疗效。方法 回顾性纳入2022年12月—2023年12月航天中心医院接受PCI治疗的220例急性冠脉综合征患者，按照治疗方法不同将患者分为对照组（阿司匹林单药，n＝110）和治疗组（阿司匹林＋氯吡格雷，n＝110）。PCI术后对照组服用阿司匹林肠溶片，100 mg/d；治疗组服用阿司匹林肠溶片100 mg/d，硫酸氢氯吡格雷片75 mg/d。两组用药12个月，均电话随访或门诊随访资料齐全。观察两组的临床疗效和主要不良心血管事件（MACE）发生率，比较两组治疗前后血小板功能、凝血指标和左心室功能指标。结果 治疗组总有效率（94.55%）显著高于对照组（83.64%）（P＜0.05）。治疗后，两组血小板聚集率、ADP诱导聚集、D-二聚体水平均显著降低，而出血时间显著延长（P＜0.05）；治疗后，治疗组血小板聚集率、ADP诱导聚集、D-二聚体水平低于对照组，出血时间长于对照组（P＜0.05）。治疗后，两组左室射血分数（LVEF）显著升高，左室收缩末期内径（LVESd）与舒张末期内径（LVEDd）显著降低（P＜0.05）；治疗后，治疗组LVESd和LVEDd显著低于对照组（P＜0.05）。治疗过程中，治疗组和对照组MACE发生率分别是10.91%、23.64%，两组比较差异显著（P＜0.05）。结论 针对PCI术后的急性冠脉综合征患者，阿司匹林联合氯吡格雷治疗12个月，在提高临床疗效、降低MACE风险及抑制血小板活化方面显著优于阿司匹林单药治疗，且未增加严重安全性风险，整体获益显著。

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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