摘要
目的 探究替格瑞洛在急性ST段抬高型心肌梗死（STEMI）合并糖尿病患者行经皮冠状动脉介入术（PCI）上的临床疗效及安全性。方法 将我院于2011年10月~2015年9月收治的124例急性STEMI合并糖尿病患者纳入本次研究,所有入选患者均行急诊PCI治疗,按照用药种类的不同上述患者均分为替格瑞洛组和氯吡格雷组。对比用药前后两组患者的血小板聚集率及PCI手术前后两组患者的心功能水平变化。并在PCI术后1年对两组患者的TIMI血流情况进行分级比较,同时对两组患者的心血管事件发生情况及出血风险发生情况进行比较。结果 用药前,两组患者在血小板聚集率上无明显差异（P〉0.05）,用药后1 h、24 h、48 h,替格瑞洛组的血小板聚集率明显低于氯吡格雷组（P〈0.05）;术后1年,替格瑞洛组的TIMI血流分级优于氯吡格雷组,同时替格瑞洛组的LVEF及LVEDD水平与氯吡格雷组比较也存在显著性差异,组间差异有统计学意义（P〈0.05）;1年后,替格瑞洛组的心血管事件发生率为4.48%,氯吡格雷组为16.13%,两组比较差异显著（P〈0.05）,而两组患者出血风险发生上比较无显著性差异（P〉0.05）。结论在急性STEMI合并糖尿病患者行急诊PCI治疗上,替格瑞洛的临床疗效优于氯吡格雷,其抗血小板聚集效果优于氯吡格雷,安全性良好。
Objective To research efficacy and safety of ticagrelor on patients with acute ST segment elevation myocardial infarction（ STEMI） complicated with diabetes mellitus undergoing emergency percutaneous coronary intervention（ PCI）. Methods From October 2011 to September 2015,124 cases of acute STEMI with diabetes mellitus in our hospital were included in this research,all selected patients were treated with emergency PCI. According to the different types of medication,the patients were divided into ticagrelor group and clopidogrel group. Before and after treatment,compared the platelet aggregation rate and the changes in cardiac function in the two groups. After 1 year,compared the TIMI blood flow of the two groups,and at the same time,compared the incidence of cardiovascular events and bleeding risk between the two groups at 1 months after operation. Results Before treatment,there was no significant difference in platelet aggregation rate between the two groups（ P〉0. 05）. After 1 h,24 h,48 h,the platelet aggregation rates of ticagrelor group were significantly lower than that of clopidogrel group（ P〈0. 05）. After 1 year,the TIMI flow grade of ticagrelor group was better than clopidogrel group,and the LVEF and LVEDD of ticagrelor group also had significant difference,and the differences between the two groups had statistical significance（ P〈0. 05）. After 1 year,the incidence rate of cardiovascular of ticagrelor group was 4. 48%,clopidogrel group was 16. 13%,the difference between the two groups was significant（ P〈0. 05）,and there was no significant difference in the incidence of bleeding risk between the two groups（ P〉0. 05）. Conclusion In emergency PCI therapy of patients with acute STEMI complicated with diabetes mellitus,the clinical efficacy of ticagrelor is better than clopidogrel,the effect of platelet aggregation is better than clopidogrel,the security is good.
出处
《血栓与止血学》
2016年第6期607-610,共4页
Chinese Journal of Thrombosis and Hemostasis
关键词
替格瑞洛
急性ST段抬高型心肌梗死
糖尿病
经皮冠状动脉介入术
Ticagrelor
Acute ST segment elevation myocardial infarction
Diabetes mellitus
Percutaneous coronary intervention
