阿司匹林联合替格瑞洛在老年急性冠状动脉综合征非血运重建患者中的临床观察  

Clinical application of combined aspirin and ticagrelor in non-revascularized elderly acute coronary syndrome patients

作　　者：高燕[1] 钟萍[1] 张乃文[1] 季选秀[1] 黄相丽[1] 苏莉[1] 李冬琳[1] 王海珍[1] 

机构地区：[1]原济南军区总医院干二科,250031

出　　处：《中华老年心脑血管病杂志》2017年第11期1149-1152,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：2013年总后保健专项课题(13BJZ07)

摘　　要：目的探讨不同的双联抗血小板组合用于高龄老年急性冠状动脉综合征(ACS)非血运重建患者的有效性和安全性。方法入选住院的≥75岁的ACS且非血运重建患者109例,60例用阿司匹林联合氯吡格雷治疗为对照组,49例应用阿司匹林联合替格瑞洛治疗为试验组。研究主要终点为随访1、6及12个月的主要不良心脑血管事件(MACCE)和全因死亡的发生率;次要终点为一般不良事件的发生率。结果试验组随访期间累计MACCE发生率较对照组降低(49.0%vs 70.0%,P=0.03),全因死亡发生率高于对照组,但无显著差异(12.2%vs 11.6%,P=0.93)。试验组2例(4.1%)出现呼吸困难,2组出血事件比较差异无统计学意义(P>0.05)。结论阿司匹林联合替格瑞洛用于高龄老年ACS非血运重建患者安全有效,可作为氯吡格雷低反应者的替代治疗。Objective To study the efficacy and safety of different dual antiplatelet combinations in non-revascularized elderly ACS patients.Methods One hundred and nine ≥75 years old non-revascularized ACS patients admitted to our hospital were divided into control group receiving combined aspirin and clopidogrel therapy（n=60）and experimental group undergoing combined aspirin and ticagrelor therapy（n=49）.The primary end points were the incidence of MACCE and allcause mortality during the 1-,6-,and 12-month follow-up.The secondary end points included the incidence of general adverse events（including bleeding,allergies,dyspnea）,platelet count,liver and kidney function.Results The cumulative incidence of MACCE was significantly lower in experimental group than in control group during the 1-,6-,and 12-month follow-up（49.0% vs70.0%,P=0.03）.However,no significant difference was found in the incidence of all-cause mortality between the two groups（12.2% vs 11.6%,P=0.93）and in the platelet count,liver and kidney function between the two groups before and after treatment（P〈0.05）.Dyspnea occurred in 2 patients（4.1%）of experimental group.However,no significant difference was found in the bleeding events between the two groups（P〈0.05）.Conclusion Combined aspirin and ticagrelor therapy is safe and effective for non-revascularized elderly ACS patients and can thus be used as a substitute for those with a low reaction to clopidogrel.

关 键 词：急性冠状动脉综合征 血小板聚集抑制剂 氯吡格雷 替格瑞洛 

分 类 号：R541.4[医药卫生—心血管疾病]