替格瑞洛对比氯吡格雷在PCI治疗急性冠脉综合征中的临床疗效观察  

Comparative observation the clinical effectiveness and safety evaluation for Ticagrelor vs Clopidogrel on patients undergoing percutaneous coronary intervention with acute coronary syndrome

作　　者：赵子粼[1] 覃善都[1] 黄梁艳[1] 马武芝[1] 罗建春[1] 

机构地区：[1]中国人民解放军第三0三医院心血管科,广西南宁530021

出　　处：《吉林医学》2015年第15期3213-3215,共3页Jilin Medical Journal

摘　　要：目的:对比分析急性冠脉综合征(ACS)患者PCI治疗中应用替格瑞洛与氯吡格雷的临床疗效及安全性。方法:选择择期行PCI手术的急性冠脉综合征(ACS)患者72例,随机分为对照组(氯吡格雷负荷剂量300 mg,维持剂量75 mg,1次/d,n=35例)和观察组(替格瑞洛负荷剂量180 mg,维持剂量90 mg,2次/d,n=37例)。随访3个月,观察患者血小板聚集率(PAR)变化情况,药物不良反应及心源性死亡、卒中事件发生率、再发ACS等不良心脑血管事件(MACCE)发生率。结果:替格瑞洛观察组血小板聚集率明显低于氯吡格雷对照组(P<0.05);对照组发生ACS事件2例,观察组ACS事件(P<0.05);对照组呼吸困难的发生率明显低于观察组(P<0.05);对照组和观察组出血发生率分别为10%、7.5%,差异无统计学意义(P>0.05);两组患者均未发生心源性死亡和脑卒中事件(P>0.05)。结论:对择期行PCI的ACS患者,替格瑞洛早期血小板抑制作用更显著,且不增加出血事件,可更好地降低术后再发心梗的发生。Objective Comparative observation the clinical effectiveness and safety evaluation for Ticagrelor vs Clopidogrel on patients with ACS undergoing PCI. Method 72 ACS patients were randomly divided into two groups, control group （ n = 35, clopidogrel starting dose 300 rag,followed by 75 mg,qd） and Observation group（n =37 ,ticagrelor starting dose 180 rag,followed by 90 rag,bid） ,The primary efficacy end point was ADP -induced platelet aggregation. The secondary end points were cardiovascular death, myocardial infarction （MI）, stroke and the drug adverse events. Results The results of piatelet aggregation rate for the observation group was significantly lower than control group （P 〈0. 05） ;2 cases myocardial infarction events occurred in the control group,the observation group without myocardial infarction events （P 〈0. 05） ;the dyspnea of control group were significantly lower than the observation group（P 〈0. 05） ;the bleeding incidence rates of the ob- sercation group and the control group were 10% ,7.5% ,respectively. The difference was not statistically significant （P 〉0. 05） ;there were not cardiac death and stroke events of two groups （P 〉 0. 05 ）. Conclusion Therapy of ticagrelor can significantly improve symptoms and signs in patients with acute coronary syndrome undergoing PCI, significantly platelet inhibition, and reduce the risk of major adverse cardiac events without increasing severe bleeding.

关 键 词：急性冠状动脉综合征 替格瑞洛 氯吡格雷 经皮冠状动脉介入治疗 

分 类 号：R541.4[医药卫生—心血管疾病]