替格瑞洛联合阿司匹林治疗急性冠状动脉综合征的临床研究  

Clinical trial of ticagrelor combined with aspirin in the treatment of acute coronary syndrome

作　　者：贾珠银 杨建敏[2] 

机构地区：[1]温州市中心医院心血管内科,浙江温州325000 [2]杭州市第一人民医院心内科,杭州310001

出　　处：《中国临床药理学杂志》2016年第14期1254-1256,1282,共4页The Chinese Journal of Clinical Pharmacology

基　　金：浙江省医药卫生一般研究计划基金资助项目(2012KYB152)

摘　　要：目的观察替格瑞洛联合阿司匹林治疗急性冠状动脉综合征的临床疗效及安全性。方法将84例急性冠状动脉综合征患者随机分为对照组42例和试验组42例。2组患者术前均予以口服阿司匹林150 mg和硫酸氢氯吡格雷300mg,qd,持续用药7 d。术后,对照组予以口服阿司匹林100 mg,qd;试验组在对照组的基础上,予以口服替格瑞洛90 mg,qd。2组患者均治疗6个月。比较2组患者的临床疗效、急性心肌梗死发作次数、发作持续时间、ST段下移水平、血清肌钙蛋白T、脑钠肽、C反应蛋白、D-二聚体水平以及不良反应发生情况。结果治疗后,试验组的总有效率为95.24%(40/42例)显著高于对照组的83.33%(35/42例,P<0.05)。治疗后,试验组与对照组的急性心肌梗死发作次数分别为每周(2.02±0.23),(4.53±0.52)次;发作持续时间分别为每次(2.76±0.31),(4.14±0.43)min;ST段下移水平分别为(0.63±0.07),(1.25±0.17)m V;血清肌钙蛋白T分别为(0.25±0.03),(1.54±0.18)ng·m L^(-1);脑钠肽分别为(28.43±3.02),(63.52±6.73)ng·L^(-1),C反应蛋白分别为(4.57±0.55),(8.94±0.94)mg·L^(-1);D-二聚体分别为(59.54±61.74),(133.53±15.73)ng·m L^(-1),且试验组治疗后的上述指标均显著低于对照组(P<0.05)。2组患者不良反应均以消化系统和神经系统症状为主,试验组的不良反应发生率为7.14%显著低于对照组的16.67%(P<0.05)。结论替格瑞洛联合阿司匹林治疗急性冠状动脉综合征的临床疗效显著,且安全性较高。Objective To evaluate the clinical efficacy of ticagrelor combined with aspirin in the treatment of acute coronary syndrome.Methods Eighty- four patients with acute coronary syndrome were randomly divided into control group（ n = 42） and treatment group（ n = 42）.Two groups were received aspirin 150 mg oral,qd ＋ clopidogrel bisulfate 300 mg oral,qd for 7 days before operative. Control group was received aspirin 100 mg oral,qd for 6 months after operation. Treatment group was received aspirin 100 mg oral,qd,and ticagrelor 90 mg oral,qd for 6months. The clinical efficacy,the number of acute myocardial infarction,the levels of ST segment depression,serum cardiac troponin T（ cTnT）,brain natriuretic peptide（ BNP）,C reactive protein（ CRP）,D- dimer,and incidence of adverse drug reactions were compared betweentwo groups. Results After treatment,the total effective rate of treatment group was 95. 24%（ 40 /42）,which was significantly higher than that of control group [83. 33%（ 35 /42）,P〈0. 05]. After treatment,the main observation indexes in treatment and control group： the attack times of acute myocardial infarction were（ 2. 02 ± 0. 23）,（ 4. 53 ± 0. 52） times per week; the attack duration were（ 2. 76 ± 0. 31）,（ 4. 14 ± 0. 43） min each time; the down level of ST were（ 0. 63 ± 0. 07）,（ 1. 25 ± 0. 17） m V; c Tn T were（ 0. 25 ± 0. 03）,（ 1. 54 ± 0. 18） ng·m L^-1; BNP were（ 28. 43 ± 3. 02）,（ 63. 52 ± 6. 73） ng ·L^-1; CRP were（ 4. 57 ± 0. 55）,（ 8. 94 ± 0. 94） mg·L^-1; D- dimer were（ 59. 54 ± 61. 74）,（ 133. 53 ± 15. 73） ng·m L^-1,and the attack times of acute myocardial infarction,the attack duration,the down level of ST,the levels of c Tn T,BNP,CRP and D- dimer in treatment group were significantly lower than those of control group（ P〈0. 05）. The adverse drug reactions were based on digestive and nervous system symptoms for two groups. Also,the incidence of adverse drug reactions in control group was 16. 67%,treatment

关 键 词：替格瑞洛 阿司匹林 急性冠状动脉综合征 临床疗效 安全性 

分 类 号：R972[医药卫生—药品]