替格瑞洛在急性ST段抬高型心肌梗死急诊介入术中的应用效果观察  

The effect of ticagrelor in emergency interventional therapy for acute ST segment elevation myocardial infarction

作　　者：牛红霞[1] 褚晓雯[1] 康枫[1] 陈士轩 陈熙[1] 韩永华[1] NIU Hongxia ZHU Xiaowen KANG Feng CHEN Shixuan CHEN Xi HAN Yonghua(Department of Emergency, Electric Hospital Affilated Capital Medical University, Beijing 100017, China)

机构地区：[1]首都医科大学电力教学医院急诊科,北京100017

出　　处：《疑难病杂志》2016年第10期994-997,共4页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的观察替格瑞洛在急性ST段抬高型心肌梗死(STEMI)行急诊经皮冠状动脉介入治疗(PCI)中的有效性及安全性。方法选择2014年2月—2015年12月首都医科大学电力教学医院急诊科收治的STEMI患者104例作为研究对象。按随机数字表法分为观察组和对照组各52例。治疗组术前服用阿司匹林300 mg、替格瑞洛180 mg,术后仅服用替格瑞洛180 mg;对照组术前服用阿司匹林300 mg、氯吡格雷600 mg,术后仅服氯吡格雷75 mg。观察2组术后心肌梗死溶栓治疗(TIMI)血流分级、无复流率、血小板计数、血小板抑制率、心血管不良事件发生率。结果治疗组TIMI血流分级显著高于对照组,无复流率明显低于对照组(Z=6.022,x^2=4.031,P=0.049、0.045);治疗组血小板抑制率明显高于对照组(t=3.210,P=0.000)。治疗组1个月后心脏不良事件发生率明显低于对照组(x^2=4.412,P=0.038),2组出血事件比较差异无统计学意义(x^2=1.352,P=0.254)。结论替格瑞洛对急性STEMI行急诊PCI患者抗栓效果确切,安全性较好。Objective To observe efficacy and safety of ticagrelor in patients with acute ST elevation myocardial in-farction （STEMI） undergoing emergency percutaneous coronary intervention （PCI）.Methods Totally 108 patients, who were from the emergency department of electric teaching hospital of capital medical university during 2014 Feb to 2015 Dec, they were selected as research subjects.All the patients were randomly divided into treatment group and control group.Pa-tients in the treatment group were given aspirin 300 mg ticagrelor 180 mg before PIC, and were given ticagrelor 180 mg only after PIC.Patients in the control group were given aspirin 300 mg clopidogrel 600 mg before PIC, and they were given clopi-dogrel 75mg only after PCI.Thrombolysis in myocardial infarction （TIMI）, no reflow events, platelet count, platelet inhibi-tion rate, major adverse cardiovascular events and bleeding events.Results The treatment group TIMI flow grade was signifi-cantly higher than the control group, no flow rate was significantly lower than the control group （ Z =6.022,χ2 =4.031, P =0.049, P =0.045）;the treatment group platelet inhibition rate was significantly higher than control group （ t =3.210, P =0.000） .Adverse cardiac events in treatment group after 1 months was significantly lower than the control group （χ2 =4.412, P =0.038）, the 2 groups had no statistically significant difference in bleeding events （χ2 =1.352, P =0.254）.Conclusion Antiplatelet therapy of ticagrelor on patients with STEMI undergoing PIC has good efficacy and safety.

关 键 词：急性ST段抬高型心肌梗死 经皮冠状动脉介入术 抗血小板治疗 替格瑞洛 

分 类 号：R542.22[医药卫生—心血管疾病]