摘要
目的:比较氯吡格雷与替格瑞洛治疗急性非ST段抬高型心肌梗死(NSTEMI)的临床疗效及安全性。方法:收集2013年10月-2015年11月我院心内科收治的NSTEMI患者160例,按随机数字表法分为观察组和对照组,各80例。两组患者均给予常规治疗,并以0.05μg/(kg·h)持续静脉泵入盐酸替非罗班氯化钠注射液等,对照组在常规治疗基础上口服负荷剂量的硫酸氯吡格雷片300 mg,之后剂量改为75 mg,qd;观察组在常规治疗的基础上口服负荷剂量的替格瑞洛片180 mg,之后改为90 mg,bid。两组患者均治疗1个月。比较两组患者治疗前后血小板集聚率、左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、纤维蛋白原水平,以及主要心血管事件(MACE)和出血事件发生率。结果:治疗前,两组患者血小板集聚率比较,差异无统计学意义(P>0.05);治疗1周及1个月后,两组患者血小板集聚率显著降低,且观察组显著低于对照组,差异均有统计学意义(P<0.05)。治疗1周后,两组患者LVEF、LVEDD水平比较,差异无统计学意义(P>0.05);治疗1个月后,观察组患者LVEF显著升高,且显著高于对照组,对照组患者LVEDD显著降低且显著低于观察组,差异均有统计学意义(P<0.05)。治疗前、治疗3 d后,两组患者纤维蛋白原水平比较,差异无统计学意义(P<0.05);治疗1周、1个月后,两组患者纤维蛋白原水平均显著降低,且观察组显著低于对照组,差异均有统计学意义(P<0.05)。观察组患者MACE事件发生率为11.25%,显著低于对照组的25.00%,差异有统计学意义(P<0.05);两组患者出血率比较(3.75%vs.7.50%),差异无统计学意义(P>0.05)。结论:与氯吡格雷比较,替格瑞洛能有效抑制NSETMI患者血小板集聚,降低纤维蛋白原水平,提高心功能,改善预后,同时并未增加出血风险,安全性较高。
OBJECTIVE： To compare clinical efficacy and safety of clopidogrel and ticaprelor in the treatment of acute non-ST elevation myocardial infarction （NSTEMI）. METHODS： A total of 160 NSTEMI patients admited in cardiovascular disease depart- ment of our hospital during Oct. 2013-Nov. 2015 were divided into observation group and control group according to random num- ber table, with 80 cases in each group. Both groups received routine treatment and continues intravenous pump of Tirofiban hydro- chloride sodium chloride injection at 0.05 p.g/（kg, h）. Control group was additionally given oral loading-dose of Clopidogrel hydro- gensultate tablet 300 mg, adjusted to 75 mg, qd, on the basis of routine treatment. Observation group was additionally given oral loading-dose of ticaprelor 180 mg, adjusted to 90 mg, bid, on the basis of routine treatment. Both groups received 1 month of treat- ment. The rate of platelet aggregation, LVEF, LVEDD, fibrinogen levels, the incidence of MACE and bleeding events were com- pared in 2 groups before and after treatment. RESULTS： Before treatment, there was no statistical significance in the rate of plate- let aggregation between 2 groups （P〉0.05）. After 1 week and 1 month of treatment, the rates of platelet aggregation in 2 groups were decreased significantly, and the observation group was significantly lower than the control group, with statistical significance （P〈0.05）. After 1 week of treatment, there was no statistical significance in the levels of LVEF or LVEDD between 2 groups （P〉 0.05）. After 1 month of treatment, LVEF of observation group was significantly higher than that of control group, LVEDD was sig-nificantly lower than control group, with statistical significance （P〈0.05）. There was no statistical significance in the level of fi- brinogen before treatment and after 3 d of treatment （P〈0.05）. After 1 week and 1 month of treatment, the levels of fibrinogen in 2 groups were decreased significantly, and the observation group was signi
出处
《中国药房》
CAS
北大核心
2017年第32期4544-4547,共4页
China Pharmacy
