心肌梗死患者经皮冠状动脉介入术术后双抗血小板治疗变替格瑞洛单抗治疗的可行性分析  

Feasibility Analysis of dual Antiplatelet Therapy Change into Ticagrelor Monoclonal Antibody Therapy in Patients with Myocardial Infarction After PCI

作　　者：杨红丽[1] 刘华云[1] 严亚林[1] 彭丁[1] 

机构地区：[1]武汉亚洲心脏病医院心内科,武汉430022

出　　处：《血栓与止血学》2017年第3期433-435,共3页Chinese Journal of Thrombosis and Hemostasis

摘　　要：目的分析心肌梗死患者经皮冠状动脉介入术(PCI)后双抗血小板治疗变替格瑞洛单抗治疗的可行性。方法 2013年6月至2015年6月共收集90例心肌梗死患者为研究对象,依据随机数字表格法将患者分为两组各45例,均行PCI治疗,术后均给予阿司匹林+替格瑞洛双联抗血小板治疗,对照组双抗用药1年,观察组双抗6个月后开始慢慢减少阿司匹林应用,3个月后完全变替格瑞洛单抗治疗,共用药1年,比较2组治疗前后凝血指标、血小板聚集率、不良心血管事件及出血事件。结果与治疗前比较,2组治疗1年PT、aPTT明显延长,血小板聚集率明显下降,差异有统计学意义(P<0.05);2组不良心血管事件及出血事件比较差异无统计学意义(P>0.05)。结论心肌梗死患者PCI术后阿司匹林+替格瑞洛双联抗血小板治疗6个月变替格瑞洛单抗用药至1年相比双联1年在抑制血小板聚集方面作用类似,但变替格瑞洛单抗治疗能有效减少出血发生,且不显著增加不良心血管事件。Objective To analyze feasibility of dual antiplatelet therapy change into ticagrelor monoclonal antibody therapy in patients with myocardial infarction after percutaneous coronary intervention （PCI）. Methods 90 patients with myocardial infarction from June 2013 to June 2015 were selected as the research objects,they were divided by random number table into two groups （ each 45 cases） , all patients underwent PCI therapy, they all received aspirin ＋ ticagrelor dual antiplatelet therapy for 1 year, the control group received 1 year of dual antiplatelet therapy, after 6 months of dual antiplatelet, the observation group began to decrease the use of aspirin slowly, then changed into ticagrelor monoclonal antibody therapy after 3 months ,the therapy lasted for 1 year, coagulation indexes, platelet aggregation rates, adverse cardiovascular events and bleeding events in the two groups before and after the treatment were compared. Results Compared with those before the treatment, PT and APTT after 1 years of therapy in the two groups were significantly prolonged, platelet aggregation rates were decreased significantly （ P 〈 0. 05 ） ; there was no significant difference in adverse cardiovascular events and bleeding events in the two groups （P 〉 0. 05 ）. Conclusion Aspirin ＋ ticagrelor dual antiplatelet therapy for 6 months and changes into ticagrelor monoclonal antibody therapy to 1 year and 1 year dual therapy have similar effect on platelet aggregation inhibition in patients with myocardial infarction after PCI, but change into ticagrelor monoclonal antibody therapy can reduce bleeding effectively, and it does not increase adverse cardiovascular events.

关 键 词：心肌梗死 双联抗血小板 替格瑞洛 心血管事件 出血事件 

分 类 号：R541.4[医药卫生—心血管疾病]