摘要
目的观察老年女性急性冠状动脉综合征(acute coronary syndrome,ACS)行PCI的患者应用双联抗血小板治疗1年的临床结局。方法入选2016年1月~2017年12月因ACS首次入我院且行PCI的老年女性患者284例,随机分为氯吡格雷组129例和替格瑞洛组155例,2组均服用阿司匹林,分别加服氯吡格雷或替格瑞洛,用比浊法检测血小板聚集率,平均随访1年,比较2组患者血小板聚集率、支架内血栓和出血事件。结果2组花生四烯酸诱导的血小板聚集率比较无统计学差异(P>0.05);氯吡格雷组二磷酸腺苷诱导的血小板聚集率高于替格瑞洛组[(36.43±23.17)%vs(13.88±11.48)%,P<0.05];氯吡格雷组与替格瑞洛组支架内血栓(0.8%vs 0.6%)、TIMI定义的大出血(0.8%vs 2.6%)、颅内出血(0.8%vs 1.3%)发生率比较,均无统计学差异(P>0.05),替格瑞洛组TIMI定义的少量出血(7.7%vs 1.6%)及不明显出血(9.0%vs 2.3%)发生率明显高于氯吡格雷组(P<0.05),氯吡格雷组与替格瑞洛组出血事件发生率比较,差异有统计学意义(4.7%vs 19.4%,P<0.01)。结论ACS患者用替格瑞洛的支架内血栓与氯吡格雷无统计差异,出血事件中,主要是少量出血及不明显出血较氯吡格雷增加。
Objectiive To study the clinical outcome in elderly female acute coronary syndrome(ACS)patients who underwent PCI after 1-year double antiplatelt therapy.Methods Two hundred and eighty-four elderly female ACS patients who underwent PCI in our hospital from January 2016 to December 2017 were randomly divided into clopidogrel treatment group(n=129)and ticagrelor treatment group(n=155).The patients in two groups were treated with aspirin+clopidogrel and aspirin+ticagrelor respectively.The platelet aggregation rate in two groups was detected by turbidimetry.The patients were followed up for 1 year,during which the platelet aggregation rate,thrombotic and bleeding events were recorded and compared.Results No significant difference was detected in arachidonic acid-induced platelet aggregation rate between the two groups(P>0.05).The ADP-induced platelet aggregation rate was significantly higher in clopidogrel treatment group than in ticagrelor treatment group(36.43%±23.17%vs 13.88%±11.48%,P<0.05).No significant difference was detected in incidence of instent thrombosis,TIMI-defined major bleeding and intracranial bleeding between the two groups(0.8%vs 0.6%,0.8%vs 2.6%,0.8%vs 1.3%,P>0.05).The TIMI-defined incidence of minor bleeding and insignificant bleeding was significantly higher in ticagrelor treatment group than in clopidogrel treatment group(7.7%vs 1.6%,P<0.05;9.0%vs 2.3%,P<0.05).The incidence of bleeding events was significantly lower in clopidogrel treatment group than in ticagrelor treatment group(4.7%vs 19.4%,P<0.01).Conclusion No significant difference is detected in intent thrombosis in elderly female ACS patients after clopidogrel and ticagrelor treatment.The incidence of minor bleeding and insignificant bleeding is higher in patients after ticagrelor treatment than in those after clopidogrel treatment.
作者
苏斌
刘迎午
刘搏江
王赟赟
皮淑芳
彭文近
刘艳红
王辉
王丹
Su Bin;Liu Yingwu;Liu Bojiang;Wang Yunyun;Pi Shufang;Peng Wenjin;Liu Yanhong;Wang Hui;Wang Dan(Center of Cardiology,Tianjin No.3 Central Hospital,Tianjin 300171,China)
出处
《中华老年心脑血管病杂志》
北大核心
2021年第5期495-498,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
天津市科技计划项目(16ZXMJSY00200)。
