摘要
目的观察替格瑞洛与氯吡格雷对急性冠状动脉综合征(ACS)患者经皮冠状动脉介入(PCI)术后不良心脏事件的影响。方法选取2014年7月—2015年8月辽宁省阜新矿业(集团)有限责任公司总医院心血管科接受冠状动脉造影确诊为ACS并成功完成PCI的96例患者为研究对象,按随机数字表法分为氯吡格雷治疗组(对照组)与替格瑞洛治疗组(观察组),每组48例。对照组接受阿司匹林+氯毗格雷治疗,观察组接受阿司匹林+替格瑞洛治疗,观察比较2组患者治疗前和治疗后24 h、1周和1个月血小板最大聚集率(MPAR),P2Y12反应单位(PRU),治疗期间不良反应及随访6个月内不良心脏事件及出血事件。结果治疗后2组MPAR和PRU均较治疗前降低(P<0.05),而cTnI含量在24 h内较治疗前升高,随后逐渐降低,观察组在术后24 h、1周和1个月MPAR、PRU和cTnI含量均明显低于对照组(P<0.05)。随访6个月,观察组不良心脏事件发生率(8.33%)显著低于对照组(27.08%)(x^2=4.575,P=0.032)。2组患者出血事件和不良反应发生率比较差异无统计学意义(10.42%vs.18.75%,x^2=0.753,P=0.386;29.16%vs.33.33%,x^2=0.049,P=0.852)。结论替格瑞洛较氯吡格雷更够更好地抑制ACS患者PCI术后血小板聚集现象,降低近中期不良心脏事件的发生率,且不增加患者不良反应。
Objective To observe the effect of ticagrelor and clopidogrel on ischemic events in patients with acute coronary syndrome（ACS） after percutaneous coronary intervention（PCI）.Methods A total of 96 cases with ACS successfully undergoing PCI between July 2014 and August 2015 were enrolled in the study.They were divided into the clopidogrel treatment group（control group） and ticagrelor treatment group（observation group） by the random number table method,48 cases in each group.The control group was treated with aspirin and clopidogrel while the observation group was treated with aspirin and ticagrelor.Before treatment,24 h,I week and 1 month after treatment,the maximum platelet aggregation rates（MPAR）,P2Y12 reaction unit（PRU）,adverse reactions in the two groups during treatment,adverse cardiac events and bleeding events within six months were observed and compared between the two groups.Results There were significant differences in MPAR,PRU and cTnI within group,at different time points and between groups at different time points（within group：F =4.587,F =2.841,F =3.651,P〈0.05,at different time points：F =16.254,F = 12.854,F = 15.021,P〈0.05,between groups at different time points：F = 13.578,F = 10.149,F = 12.574,P 〈 0.05）.In six months of follow up,the incidence of ischemic events was significantly lower in the observation group than the control group（8.33%vs 27.08%）（x2=4.575,P =0.032）.There was no significant difference in the incidence of bleeding events and adverse reactions between the two groups（x2= 0.753,x2= 0.049,P = 0.386,P = 0.852）.Conclusion Compared with clopidogrel,ticagrelor can better inhibit platelet aggregation in patients with ACS after PCI,reduce the incidence of adverse cardiovascular events,without increasing adverse reactions.
作者
金春
宋颖
祖武
李婷婷
JIN Chun SONG Ying ZU Wu LI Tingting.(Department of Cardiology, General Hospital of Fuxin Mining （Group） Co. , Ltd. , Ltaoning Province, Fuxin 123000, China)
出处
《疑难病杂志》
CAS
2017年第5期433-436,共4页
Chinese Journal of Difficult and Complicated Cases
基金
2016年度中国煤炭工业协会科学技术研究指导性计划项目(MTKJ2016-348)
