摘要
【目的】探讨非ST段抬高型急性冠状动脉综合征（NSTE-ACS）患者经皮冠脉支架置入术（PCI）治疗后应用替格瑞洛双抗血小板治疗的远期疗效。【方法】回顾性分析2013年5月至2016年1月本院收治的500例经冠状动脉造影确诊为NSTE-ACS并行PCI术治疗的患者的临床资料。根据术后抗血小板治疗方案的不同分为观察组（n=256）和对照组（n=244）。观察组术后给予替格瑞洛双抗血小板治疗,对照组术后给予常规双抗血小板治疗,观察比较两组患者治疗前和治疗后生化指标及左心室射血分数（LVEF）指标,不良反应及2年内主要心血管不良事件（MACE）及出血事件。【结果】治疗后,两组血清肌酐（Cr）、LVEF水平显著升高,观察组Cr、LVEF指标显著高于对照组（P〈0.05）;两组治疗后血清肌酸激酶同工酶（CK-MB）、肌钙蛋白I（cTnI）、血小板最大聚集率（MPAR）水平较治疗前显著降低,且观察组下降幅度显著大于对照组,差异具有统计学意义（P〈0.05）。随访12个月和24个月后,观察组患者总MACE发生率、总出血事件发生率显著低于对照组,差异具有统计学意义（P〈0.05）。观察组不良反应发生率为11.33%（29/256）,对照组为14.75%（36/244）,两组患者不良反应发生率比较,差异不具有统计学意义（χ2=1.296,P〉0.05）。【结论】替格瑞洛对NSTE-ACS患者PCI术后血小板聚集具有很好的抑制作用,具有起效快,药效稳定并不增加患者不良反应,可降低远期MACE发生率,值得临床推广使用。
【Objective】To investigate the long-term effect of tigrilol dual antiplatelet therapy after percutaneous coronary stenting （PCI） in patients with non-ST-segment elevation acute coronary syndrome （NSTE-ACSC）.【Methods】The clinical data of 500 patients diagnosed by coronary angiography and treated with PCI from May 2013 to January 2016 were retrospectively analyzed. The patients were divided into two groups： the observation group （n=256） and the control group （n=244）. The patients in the observation group were treated with tigrello double antiplatelet therapy, and the control group were treated with routine double antiplatelet therapy. The biochemical indexes and left ventricular ejection fraction （LVEF） were observed and compared before and after treatment in the two groups. Adverse reactions and major adverse cardiovascular events within 2 years （MACEE） and bleeding events.【Results】After treatment, the levels of serum creatinine and LVEF in the two groups were significantly higher than those in the control group. The indexes of Cr and LVEF in the observation group was significantly higher than those in the control group （P〈0.05）. The serum creatine kinase isoenzyme （CK-MB）, troponin I （cTnI） and platelet maximum aggregation rate （MPAR） in the two groups were significantly lower than those before treatment, and the decrease in the observation group was significantly higher than that in the control group （P〈0.05）. After 12 and 24 months follow-up, the incidence of total MACE and total haemorrhage events in the observation group was significantly lower than that in the control group, After 12 and 24 months follow-up, the incidence of total MACE and total haemorrhage events in the observation group was significantly lower than that in the control group, the difference was statistically significant （P〈0.05）. The incidence of adverse reactions in the observation group was 11.33% （29/256） and in the control group was 14.75% （36/244）.There was no s
作者
张桂霞
李大鹏
王环宇
张明亮
李志
ZHANG Gui-xia;LI Da-peng;WANG Huan-yu;et al(Department of Cardiology, Jiamusi Central Hospital, Heilongjiang Province, Jiamusi 154002)
出处
《医学临床研究》
CAS
2018年第4期672-674,678,共4页
Journal of Clinical Research
