替格瑞洛在不稳定型心绞痛经皮冠状动脉介入治疗病人中应用的临床疗效观察  

Clinical efficacy observation of the application of ticagrelor for PCI patients with unstable angina pectoris

作　　者：吕留强[1] 唐扬章[1] 王士强[1] 张怀金[1] 赵立[1] 鲁晓[1] 

机构地区：[1]淮北市人民医院心内科,安徽淮北235000

出　　处：《安徽医药》2017年第4期728-730,共3页Anhui Medical and Pharmaceutical Journal

摘　　要：目的观察替格瑞洛在不稳定型心绞痛(UA)经皮冠状动脉介入治疗(PCI)病人中应用的临床疗效及安全性。方法 114例UA已行PCI治疗的病人,分为对照组57例(氯吡格雷PCI术前负荷量300 mg,维持量75 mg,每天1次口服)和治疗组57例(替格瑞洛PCI术前负荷量180 mg,维持量90 mg,每天2次口服)。分别观察PCI术中两组血栓事件发生率及冠脉血流情况,并对PCI术后病人1、3、6、12个月进行随访,观察两组病人术后1年再发心绞痛、心肌梗死、心源性猝死、卒中等心脑血管不良事件发生率及药物不良反应。结果两组术中急性血栓形成发生率相近,差异无统计学意义(P>0.05);术中治疗组冠脉血流分级明显好于对照组,对照组发生急性冠脉综合征(ACS)16例,治疗组发生ACS 7例,差异有统计学意义(P<0.05)。呼吸困难和出血事件发生率,对照组和治疗组均差异无统计学意义(P>0.05);两组均未发生心源性猝死和卒中(P>0.05)。结论应用替格瑞洛能改善UA病人PCI术中冠脉血流,降低术后ACS事件的再发生率,并且出血事件的发生率不会增加。Objective To investigate the clinical efficacy and safety ofTicagrelor applied in PCI patients with unstable angina pectoris. Methods A hundred and fourteen cases of unstable angina pectorispatients hospitalized with PCI treatment were selected and random-ized into control group （ n = 5 7 ,Clopidogrel loading dose 300 mg before PCI, maintenance dose 75 mg qd） and treatment group （ n = 57,Ticagrelor loading dose 180 mg before PCI,maintenance dose of 90 mg bid） . Two groups were observed by the incidence of thrombo-embolic events and coronary blood flow in PCI surgery,and patients were observed after the PCI surgery in 1 month,3 ,6,and 12 months following up. Also,the observation of the recurrent angina,myocardial infarction, sudden cardiac death, stroke and other cardiovascular and cerebrovascular adverse events and adverse drug reactions to the patients one year after the surgery was conducted. Results In both groups, the occurrence of acute thrombosis was similar. There was no statistically significant difference （ P 〉 0. 05 ） . The intraopera-tive coronary blood flow grade of treatment group was significantly better than that of the control group, and the difference was statistical-ly significant. 16 cases of ACS occurred in the control group,while7 cases occurred in the treatment group （P 〈0. 05） . The occurrence rates of breathing difficulty and bleeding in the control and treatment groups were similar,and no statistically significant difference was found （P 〉0. 05） ;no sudden cardiac death and stroke in two groups was found （P 〉0. 05） . Conclusions The application of Ticagrelor could improve the coronary blood flow in the PCI patients withunstable angina pectoris, and then reduce the recurrence rate of postopera-tive ACS event,and the incidence of bleeding events would not increase.

关 键 词：不稳定型心绞痛 经皮冠状动脉介入治疗 替格瑞洛 

分 类 号：R541.4[医药卫生—心血管疾病]