摘要
目的回顾性分析575例老年及非老年急性ST段抬高型心肌梗死(STEMI)患者应用替格瑞洛或氯吡格雷的情况。方法收集575例老年及非老年STEMI患者的临床资料,其中>65岁的老年患者154例、≤65岁的非老年患者421例。根据患者年龄以及临床治疗中与阿司匹林联用的双联抗血小板药物不同,分为老年替格瑞洛组111例、老年氯吡格雷组43例、非老年替格瑞洛组313例、非老年氯吡格雷组108例。收集患者的临床资料、院内死亡等资料并比较各组差异。结果非老年替格瑞洛组的D-二聚体、脑钠肽(BNP)最高值及肌钙蛋白最高值均低于非老年氯吡格雷组(P<0.05)。老年替格瑞洛组D-二聚体低于老年氯吡格雷组(P=0.029)。非老年替格瑞洛组院内病死率低于非老年氯吡格雷组(P=0.012)。老年替格瑞洛组与老年氯吡格雷组相比院内病死率差异无统计学意义(P=0.340)。结论对于≤65岁的非老年STEMI患者,与应用氯吡格雷相比,应用替格瑞洛患者的院内病死率较低;对于>65岁的老年STEMI患者,以上两种方案对院内病死率的影响未见明显统计学差异。
Objective To analyse the effects of ticagrelor versus clopidogrel in 575 elderly and non-elderly patients with ST-segment elevation myocardial infarction(STEMI).Methods According to the age,575 STEMI patients were di⁃vided into elderly group(154 cases)and non-elderly group(421 cases).According to the different antiplatelet therapy,pa⁃tients in elderly group were divided into elderly ticagrelor subgroup(111 cases)and elderly clopidogrel subgroup(43 cas⁃es);patients in non-elderly group were divided into non-elderly ticagrelor subgroup(313cases)and non-elderly clopidogrel subgroup(108cases),respectively.The clinical data and hospital death data were collected and compared among the groups.Results Levels of D-dimer,BNP and troponin in non-elderly ticagrelor subgroup were significantly lower than those of patients in non-elderly clopidogrel subgroup(P<0.05).D-dimer level in patients of elderly ticagrelor subgroup was significatly lower than that in patients of elderly clopidogrel subgroup(P=0.029).The in-hospital death rate of ticagre⁃lor subgroup was lower than that of clopidogrel subgroup in non-elderly patients(P=0.012).No significant differences of in-hospital death rate were found between two subgroups in elderly patients(P=0.340).Conclusion For patients with STEMI under 65 years old,application of ticagrelor resulted in less in-hospital death rate.No significat difference of in-hospital death rate were found between these two anti-platelet strategy in elderly STEMI patients over 65 years old.
作者
李玥
冯玉萍
黄茵
张光武
张群英
LI Yue;FENG Yuping;HUANG Yin;ZHANG Guangwu;ZHANG Qunying(Department of Geratology,The Fifth Affiliated Hospital of Sun Yat-sen University,Zhuhai 519000,China;Department of Cardiology,The First People's Hospital of Kashgar,Kashgar 844000,China;Department of Cardiology,The Fifth Affiliated Hospital of Sun Yat-sen University,Zhuhai 519000,China)
出处
《老年医学研究》
2021年第3期6-9,共4页
Geriatrics Research
基金
广东省农村科技特派员项目(KTP2020337,应用信息化技术对喀什地区心血管慢性病进行保健管理)。
