早期应用替格瑞洛对急性冠状动脉综合征急诊介入术后患者预后的影响  

The effects of early stage usage of ticagrelor on the prognosis of acute coronary syndrome patients who had emergency intervention

作　　者：姜述斌[1] 葛振嵘[1] 李岚[1] 李秀芬[1] 徐风燕[1] 

机构地区：[1]新疆医科大学附属中医医院CCU,乌鲁木齐830000

出　　处：《临床心血管病杂志》2015年第7期712-716,共5页Journal of Clinical Cardiology

摘　　要：目的:观察早期应用替格瑞洛对急性冠状动脉综合征(ACS)急诊介入术后患者预后的影响。方法:入选211例ACS拟行急诊介入治疗的患者,在冠状动脉造影前随机分为观察组104例(替格瑞洛片负荷剂量180mg,维持剂量每次90mg,每12h1次)和对照组107例(氯吡格雷片负荷剂量600mg,维持剂量75mg/d),分别在服药后第7、30、90天时进行随访,对比两组的临床终点事件(全因死亡、再发心肌梗死、支架内血栓形成、再发心肌缺血、卒中),以及安全性指标的发生率。结果:服药后第7、30、90天时观察组临床终点事件发生率低于对照组,并具有统计学意义。采用Kaplan-Meier法进行资料分析,经log rank检验,观察组生存率较对照组高,两组对比有统计学差异。服药后第7、30、90天时两组所有出血事件发生率差异无统计学意义(P>0.05)。结论:早期应用替格瑞洛对ACS急诊介入术后患者安全有效,较氯吡格雷能显著降低心血管不良事件发生率,同时不增加出血风险。Objective：To observe the effect of early stage ticagrelor usage on the prognosis of patients who underwent acute coronary syndrome emergency interventional surgery.Method：All 211 cases of acute coronary syndrome patients who have planned for emergency intervention were divided into two groups before operation：An observation group with 104 cases and a control group with 107 cases.Patients from the observational group were given a loading dose of 180 mg tricagrelor,and a maintenance dose of 90 mg tricagrelor every 12 hours thereafter.Control group patients were given a loading dose of 600 mg clopidogrel,and a maintenance dose of 75 mg clopidogrel every 24 hours thereafter.Follow up observations on the 7th,30 th,and 90 th day after taking medicine were carried out to compare the incidence of the clinical end point events（all-cause mortality,recurrent myocardial infarction,stent thrombosis,recurrent ischemia,and stroke）between the two groups,as well as the safety index.Result：On the 7th,30 th,and 90 th day after taking medicine,the observational group had significantly lower incidence of clinical end point events compared to the control group.The survival rate of the observational group was significantly higher than that of the control group using the Kaplan-Meier analysis method and log rank test.The occurrence rates of bleeding events between the two groups on the 7th,30 th,and 90 th day after taking medicine were not statistically different（P〉0.05）.Conclusion：Early stage application of Ticagrelor is safe and effective on patients who undergo acute coronary syndrome emergency interventional surgery.Compared to Clopidogrel,Ticagrelor performs better at significantly decreasing the occurrence rate of clinical cardiovascular end point events,and Tricagrelor does not increase the risk of bleeding.

关 键 词：急性冠状动脉综合征 替格瑞洛 经皮冠状动脉介入治疗 

分 类 号：R541.4[医药卫生—心血管疾病]