替格瑞洛在急性冠脉综合征患者PCI术中的应用时机及安全性评价  

Evaluation in clinical administration time and safety of ticagrelor in treatment of acute coronary syndrome patients with percutaneous coronary intervention

作　　者：张杰[1] 朱善香[1] 高苓[1] 张明明[1] 王菲[1] 

机构地区：[1]解放军第八十八医院心内科,山东泰安271000

出　　处：《实用临床医药杂志》2015年第19期5-8,共4页Journal of Clinical Medicine in Practice

基　　金：中国高校医学期刊临床专项资金(11523100)

摘　　要：目的探讨替格瑞洛在急性冠脉综合征(ACS)患者经皮冠状动脉介入(PCI)术中的用药时机及安全性。方法PCI术前应用替格瑞洛的ACS患者120例为术前组,PCI术后应用的ACS患者120例为术后组,术前术后均应用氯吡格雷的ACS患者120例为对照组。观察PCI术后6个月心脏血流,术后1、3、6月心功能改善情况,PCI术后90 d主要及次要不良事件发生率,以及3组患者PCI术前、术后24 h肝肾功能、心肌酶谱等生化指标。结果 PCI术后6个月3组心脏血流均有所改善,术前组、术后组改善程度均优于对照组,术前组优于术后组(P<0.05或P<0.01);术后1、3、6个月时,术前组及术后组心脏功能显著优于对照组,术前组优于术后组(P<0.05或P<0.01)。90 d内,术前组、术后组主要不良事件发生率均低于对照组(P<0.05)。3组术后24 h术前组、术后组肝肾功能、心肌酶受影响程度低于对照组(P<0.01),且术前组影响程度显著术后组(P<0.05或P<0.01)。结论 ACS患者PCI术前应用替格瑞洛具有良好的临床疗效及安全性。Objective To explore the administration time and safety of ticagrelor in treatment of acute coronary syndrome（ ACS） patients with percutaneous coronary intervention（ PCI）. Methods A total of 120 ACS patients treated with ticagrelor before PCI were served as preoperation group,while another 120 ACS patients treated with ticagrelor after PCI were served as postoperation group. In addition,another 120 ACS patients treated with clopidogrel before and after PCI were selected as control group. Cardiac blood flow in 6 months after operation,improvement of cardiac function in 1,3 and6 months after operation,primary and secondary adverse events in 90 days after PCI,and biochemical indexes like hepatorenal function and myocardial enzymes before PCI and 24 hours after PCI were observed in all groups. Results 6 month after PCI,cardiac blood flow improved in all groups,which was the best in the preoperation group and the worst in the control group,and differences were significant（ P 0. 05 or P 0. 01）. 1,3 and 6 months after operation,cardiac function was markedly better in the preoperation and postoperation groups than in the control group,and was significantly better in the preoperation group than in the postoperation group（ P 0. 05 or P 0. 01）. Within 90 days after PCI,both preoperation and postoperation groups were prominently lower than the control group in the rate of adverse events（ P 0. 05）. 24 hours after PCI,both the preoperation and postoperation groups were prominently lower than control group in the influence severity of the drugs on patients＇ hepatorenal function and myocardial enzymes（ P 0. 01）,and preoperation group was evidently higher than the postoperation group（ P 0. 05 or P 0. 01）. Conclusion Preoperative application of ticagrelor is favorable in clinical efficacy and safety in the treatment of ACS patients with PCI.

关 键 词：替格瑞洛 用药时机 急性冠脉综合征 经皮冠状动脉介入 安全性 

分 类 号：R543.3[医药卫生—心血管疾病]