摘要
目的研究替格瑞洛对冠心病(CHD)患者经皮冠状动脉介入治疗(PCI)术后冠脉微循环功能的影响。方法选取2013年9月至2014年9月在我院进行PCI手术的冠心病患者76例为研究对象,抽签随机分为观察组(替格瑞洛)与对照组(氯吡格雷),每组38例。两组入院后均进行药物治疗与常规护理,住院期间均给予扩冠、他汀类药物、B他受体阻断剂、低相对分子质量肝素。两组术前均给予阿司匹林肠溶片,对照组加入氯吡格雷联合治疗,观察组加入替格瑞洛联合治疗。比较两组治疗前后凝血酶元时间(PT)、血小板聚集率(PAgT)和纤维蛋白原(Fbg)含量、循环抵抗指数(IMR)、冠脉血流储备(CFR);观察治疗期间出血事件发生情况;电话和门诊随访治疗后6个月、1年、2年心血管事件发生率。结果治疗后观察组PT、PAgT和Fbg值(P<0.05);观察组治疗后的IMR值为(26.80±5.97),显著低于对照组(29.87±6.14),CFR值为(2.23±0.51),显著高于对照组(1.84±0.44)(P<0.05);观察组治疗期间出血事件发生率为2.63%,明显低于对照组15.79%(P<0.05),观察组治疗后6个月、1年、2年内心血管不良事件发生率分别为5.26%、10.53%、13.16%,均显著低于对照组21.05%、28.95%、34.21%(P<0.05)。结论对冠心病患者PCI术后给予替格瑞洛抗血小板治疗,可获得优于氯吡格雷对凝血功能与冠脉微循环功能的改善效果,并降低短期、中远期心血管不良事件的发生率。
Objective To study the effect of Ticagrelor on coronary microcirculation function in patients with coronary atherosclerotic heart disease( CHD) after percutaneous coronary intervention( PCI). Methods 76 cases of patients with CHD who underwent PCI in our hospital between September 2013 and September 2014 were selected as the study subjects and were randomly divided into the observation group( Ticagrelor) and the control group( clopidogrel),with 38 cases in each group. After admission,both of the two groups were treated with drug therapy and routine nursing,and were treated with coronary dilatation,statins,βreceptor blockers and subcutaneous low molecular weight heparin. The risk factors were controlled. Before operation,the two groups were given aspirin enteric coated tablets. The control group was additionally treated with clopidogrel and the observation group was additionally treated with Ticagrelor. The prothrombin time( PT),maximum platelet aggregation rate( PAgT),fibrinogen( Fbg) content,index of microcirculation resistance( IMR) and coronary flow reserve( CFR) were compared between the two groups before and after treatment; The occurrence of bleeding events during the treatment was observed; The 6-month,1-year and 2-year incidence rates of cardiovascular events were recorded through telephone and outpatient follow-up. Results After treatment,PT,PAgT and Fbg value in the observation group( P < 0. 05); The IMR value of the observation group after treatment( 26. 80 ± 5. 97) was significantly lower than that of the control group( 29. 87 ± 6. 14) while CFR value( 2. 23 ± 0. 51) was significantly higher than that of the control group( 1. 84 ± 0. 44)( P < 0. 05); The incidence of bleeding events in the observation group during treatment( 2. 63%) was significantly lower than that in the control group( 15. 79%)( P < 0. 05). The incidence rates of adverse cardiovascular events in the observation group in 6 months,1 year and 2 years after treatment( 5. 26%,10. 53%,13. 16%) were significantly lower than those in t
出处
《血栓与止血学》
2016年第5期507-510,共4页
Chinese Journal of Thrombosis and Hemostasis
关键词
替格瑞洛
冠心病
经皮冠状动脉介入治疗
冠脉微循环功能
Ticagrelor
Coronary heart disease
Percutaneous coronary intervention
Coronary microcirculation function
