氯吡格雷和替格瑞洛对2型糖尿病合并急性冠脉综合症患者的疗效比较  

Evaluations the Effect of Ticagrelor and Clopidogrel in Treatment of Patients with type 2 Diabetes Complicated with Acute Coronary Syndrome

作　　者：王涛[1] 陆东风[1] 曾昭华[1] 卜彤[1] 罗碧辉[1] 曾智[1] 何志裕[1] 王慧勇[1] 

机构地区：[1]广州医科大学附属第一医院心血管内科,广州510120

出　　处：《血栓与止血学》2015年第6期351-354,357,共5页Chinese Journal of Thrombosis and Hemostasis

摘　　要：目的比较氯吡格雷和替格瑞洛对2型糖尿病(T2DM)合并急性冠脉综合症(ACS)患者的疗效。方法 T2DM合并ACS患者200例,随机分为替格瑞洛组和氯吡格雷组,各100例。在常规治疗的基础上,两组分别单独给予替格瑞洛(75 mg/次,2次/d)和氯吡格雷(75 mg/次,1次/d)治疗90 d。观察治疗前后两组患者的血糖、血脂、超敏C反应蛋白水平,以及不良反应。结果治疗前,两组TC、TG、LDL-C、HDL-C、FPG、Hb AIc、GSP和hs-CRP比较,差异无统计学意义(P>0.05)。和治疗前相比,治疗后替格瑞洛组TC、TG、LDL-C、FPG、GSP、hs-CRP降低明显(P<0.05),HDLC升高明显(P<0.05),Hb AIc变化不明显。氯吡格雷组的上述指标均无明显变化。替格瑞洛组出现呼吸困难3例,缓慢性心律失常2例,肌酐和尿酸升高1例。氯吡格雷组出现紫癜/瘀斑/血肿4例,鼻出血2例。结论在抗血小板的基础上,替格瑞洛能较好地改善患者的血脂和血糖状况,疗效较优。Objective To evaluate the effect of Ticagrelor and Clopidogrel in treatment of patients with type 2 diabetes（ T2DM） complicated with acute coronary syndrome（ ACS）. Methods 200 patients with T2 DM complicating with acute coronary syndrome（ ACS） were randomly divided into two groups,with 100 in each one. Besides the conventional treatment,two groups were given Ticagrelor（ 75 mg/times,2 times/d） or Clopidogrel（ 75 mg/times,1 time/d） for 90 days,separately. Blood glucose,blood lipid,hypersensitive c-reactive protein levels,and adverse reactions were observed before and after the treatment. Results Before treatment,TC、TG、LDL-C、HDL-C、FPG、Hb AIc、GSP and hs-CRP had no significant difference between the two groups（ P〈0. 05）. Compared with the results before treatment,TC,TG,LDL-C,FPG,GSP,and hs-CRP significantly decreased（ P〈0. 05）,while HDL-C obviously increased（ P〈0. 05） in Ticagrelor group. Hb AIc had no obvious alteration. Differently,these indexeshad no obvious changes in Clopidogrel group. There were 3 cases of patients with difficulty in breathing,2 cases of tardy arrhythmia,and 1 case of elevated creatinine as well as uric acid in Ticagrelor group. In the Clopidogrel group,there were 4 cases of purpura,petechial or hematoma,and 2 cases of nasal hemorrhage. Conclusion compared with Clopidogrel,Ticagrelorcan better improve the patient＇s blood glucose and blood lipid.

关 键 词：氯吡格雷 替格瑞洛 血脂 血糖 

分 类 号：R541.4[医药卫生—心血管疾病]