血栓弹力图评价替格瑞洛和氯吡格雷在急性ST段抬高型心肌梗死中抗血小板的疗效  

Evaluation of the antiplatelet effects of ticagrelor and clopidogrel in acute ST segment elevation myocardial infarction by thrombelastogram

作　　者：郭小燕[1] 冯玉宝[1] 许艳梅[1] 李永玲[1] 苏平[1] 

机构地区：[1]内蒙古医科大学鄂尔多斯临床医学院鄂尔多斯市中心医院心内科,017000

出　　处：《国际心血管病杂志》2016年第5期307-310,共4页International Journal of Cardiovascular Disease

摘　　要：目的:通过血栓弹力图评价替格瑞洛和氯吡格雷在急性ST段抬高型心肌梗死(STEMI)中抗血小板的疗效。方法:60例STEMI患者分为两组,阿司匹林+氯吡格雷组(Ⅰ组,n=30)和阿司匹林+替格瑞洛组(Ⅱ组,n=30),于抗血小板药物负荷剂量给药2 h后和维持治疗3个月后,使用血栓弹力图检测花生四烯酸(AA)途径和二磷酸腺苷(ADP)受体途径诱导的血小板抑制率。结果:抗血小板药物负荷剂量给药2 h后和维持治疗3个月后,Ⅱ组ADP受体途径诱导的血小板抑制率均明显高于Ⅰ组[(54.67±5.83)%对(45.75±16.72)%,P<0.05;(59.53±12.18)%对(45.10±16.26)%,P<0.05],AA途径诱导的血小板抑制率两组间无明显差异,患者的出血和缺血事件发生率两组间无明显差异。结论:替格瑞洛较氯吡格雷在STEMI治疗中能更快速充分地抑制血小板,血栓弹力图可用于指导STEMI患者抗血小板治疗。Objective： To evaluate the antiplatelet effects of ticagrelor and clopidogrel in acute ST segment elevation myocardial infarction （STEMI） by thrombelastogram. Methods： 60 STEMI patients were divided into two groups： aspirin ＋ clopidogrel group （group I, n = 30）, aspirin ＋ ticagrelor group （group Ⅱ , n = 30）. After giving loading dose antiplatelet drugs for 2 hours and maintenance treatment for 3 months, the platelet inhibition rates induced by arachidonic acid （AA） pathway and adenosine diphosphate （ADP） receptor pathway were detected by thrombelastogram respectively. Results： After loading dose of antiplatelet therapy and maintenance treatment, the platelet inhibition rates induced by ADP receptor pathway in group II were both significantly higher than group [（54.67±5.83）%vs（45.75±16.72）%,P〈0.05;（59.53±12.18）%对（45.10±16.26）%,P〈0.05], P〈0. 05], while the platelet inhibition rates induced by AA pathway had no significant difference between the two groups. The incidence of bleeding and ischemic events had no significant difference between the two groups. Conclusion： Ticagrelor can inhibit platelet more rapidly and fully than clopidogrel in treatment of STEMI. Thrombelastogram can be used for guiding antiplatelet therapy in STEM1 patients.

关 键 词：血栓弹力图 急性ST段抬高型心肌梗死 替格瑞洛 氯吡格雷 

分 类 号：R542.22[医药卫生—心血管疾病]