摘要
【目的】替格瑞洛治疗急性ST段抬高型心肌梗死(STEMI)患者的近期抗血小板疗效及不良反应发生情况。【方法】回顾性分析2018年1月至2020年6月本院收治的行急诊PCI治疗的85例急性STEMI患者的临床资料,根据抗血板治疗药物的不同将其分为替格瑞洛组和氯吡格雷组。比较两组患者的一般临床资料、血小板相关指标、血小板抑制率、TIMI分级、校正TIMI帧数计数,以及主要不良反应和终点事件发生情况。【结果】入院时、服药24 h后、服药7 d后,两组患者花生四烯酸抑制率(AA%)、AA诱导通路上残留的血小板活性(MA AA)比较,差异无统计学意义(P>0.05)。服药24 h后、服药7 d后,替格瑞洛组二磷酸腺苷抑制率(ADP%)高于氯吡格雷组,ADP诱导通路上残留的血小板活性(MA ADP)低于氯吡格雷组,差异有统计学意义(P<0.05)。服药7 d后,替格瑞洛组TIMI分级Ⅲ级患者所占比例高于氯吡格雷组,前降支、回旋支和右冠状动脉的校正TIMI帧数计数均低于氯吡格雷组,差异有统计学意义(P<0.05)。两组患者呼吸困难、心动过缓、皮肤瘀斑、出血等不良反应发生情况比较,差异无统计学意义(P>0.05);两组患者心源性死亡、再次心肌梗死和紧急冠脉血运重建等终点事件比较,差异无统计学意义(P>0.05)。【结论】替格瑞洛应用于行PCI治疗的STEMI患者中,其抑制血小板聚集的作用优于氯吡格雷,可减少无/慢回流的发生,且未增加不良反应和主要终点事件的发生率,安全性较好。
【Objective】To investigate the recent antiplatelet efficacy and adverse reactions of Tigrillo in the treatment of acute ST segment elevation myocardial infarction(STEMI)patients.【Methods】A retrospective analysis was conducted on the clinical data of 85 patients with acute STEMI who underwent emergency PCI treatment in our hospital from January 2018 to June 2020.They were divided into two groups based on different antiplatelet treatment drugs:the Tigrillo group and the clopidogrel group.We compared the general clinical data,platelet related indicators,platelet inhibition rate,TIMI grading,corrected TIMI frame count,as well as the occurrence of major adverse reactions and endpoint events between two groups of patients.【Results】There was no significant difference in the inhibition rate of arachidonic acid(AA%)and residual platelet activity(MA AA)in the AA induction pathway between the two groups at admission,24 hours after taking the drug,and 7 days after taking the drug(P>0.05).24 hours after administration and 7 days after administration,the inhibition rate of adenosine diphosphate(ADP%)in the Tigrillo group was higher than that in the clopidogrel group,and the residual platelet activity(MA ADP)in the ADP induction pathway was lower than that in the clopidogrel group,with a statistically significant difference(P<0.05).After 7 days of medication,the proportion of patients with TIMI grade III in the Tigrillo group was higher than that in the clopidogrel group,and the corrected TIMI frame counts of the anterior descending branch,circumflex branch,and right coronary artery were all lower than those in the clopidogrel group,with statistically significant differences(P<0.05).There was no statistically significant difference in the incidence of adverse reactions such as dyspnea,bradycardia,skin ecchymosis,and bleeding between the two groups of patients(P>0.05);There was no statistically significant difference in endpoint events such as cardiac death,recurrent myocardial infarction,and emergency coronary revasc
作者
王丽杰
韩丹宁
WANG Li-jie;HAN Dan-ning(Xi'an Xihang Hospital of Universal,Xi'an Shaanxi 710021)
出处
《医学临床研究》
CAS
2023年第5期699-702,共4页
Journal of Clinical Research
