替格瑞洛与氯吡格雷对经皮冠状动脉介入术治疗的不稳定型心绞痛患者血小板抑制作用  

Platelet inhibition effect between ticagrelor and clopidogrel in patients with unstable angina treated with percutaneous coronary intervention

作　　者：雷轩 李红[2] 金泽宁[2] LEI Xuan;LI Hong;JIN Ze-ning(Emergency and Critical Care Center,Capital Medical University,Beijing 100029,China;Department of Cardiology,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院急诊重症中心,北京100029 [2]首都医科大学附属北京安贞医院心内科,北京100029

出　　处：《中国临床药理学杂志》2019年第21期2654-2656,共3页The Chinese Journal of Clinical Pharmacology

摘　　要：目的观察替格瑞洛与氯吡格雷对经皮冠状动脉介入(PCI)治疗的不稳定型心绞痛患者血小板抑制作用。方法将接受PCI治疗的88例不稳定型心绞痛患者用随机数字表法将患者分为试验组和对照组,各44例。2组患者均进行PCI术,试验组术前服用负荷剂量替格瑞洛片180 mg,阿司匹林肠溶片600mg,术后第2天服用替格瑞洛片90 mg·d^-1,阿司匹林肠溶片100 mg·d^-1作为维持剂量;对照组术前服用负荷剂量氯吡格雷片300 mg,阿司匹林肠溶片600mg,术后第2天服用氯吡格雷片75 mg·d^-1,阿司匹林肠溶片100 mg·d^-1作为维持剂量。比较2组患者术前及术后第2天血小板抑制率,统计药物不良反应发生情况。结果对照组及试验组术后2 d腺苷二磷酸(ADP)刺激下血小板抑制率分别为(71.75±6.49)%,(65.33±5.58)%;花生四烯酸(AA)刺激下血小板抑制率分别为(69.55±7.50)%,(62.96±7.65)%,差异有统计学意义(P<0.05)。术后1个月试验组与对照组分别出现心肌梗死1,2例,反复心绞痛发作2,3例,同时对照组出现靶血管血运重建1例,试验组与对照组缺血事件发生率分别为6.82%,13.64%;试验组与对照组分别出现小出血2,5例,轻微出血4,3例,试验组与对照组出血发生率分别为13.64%,18.18%;试验组与对照组分别出现呼吸困难5,3例,胃肠道反应1,3例,心律失常1,2例,试验组与对照组其他药物不良反应发生率分别为15.91%,18.18%,差异均无统计学意义(均P>0.05)。结论替格瑞洛比氯吡格雷具有更强的抗血小板聚集作用,对不稳定型心绞痛患者PCI术后抗血小板治疗安全性相似。Objective To investigate the platelet inhibition effect between ticagrelor and clopidogrel in patients with unstable angina treated with percutaneous coronary intervention(PCI).Methods Eighty-eight patients with unstable angina who underwent PCI were divided into treatment group and control group according to random number table method,44 cases in each group.All patients were underwent PCI,treatment group was treated with loading dose of ticagrelor tablets 180 mg,aspirin intestinal tablets 600 mg pre-operation,and treated with ticagrelor tablets 90 mg·d^-1,aspirin intestinal tablets 100 mg·d^-1 as maintenance dose on 2 d post-operation;control group was treated with loading dose clopidogrel tablets 300 mg,aspirin intestinal tablets 600 mg,and treated with clopidogrel tablets 75 mg·d^-1,aspirin intestinal tablets 100 mg·d^-1 as maintenance dose on 2 d post-operation.The platelet inhibition rate of the two groups before and 2 d after operation were compared,the incidence of adverse drug reactions were observed.Results The platelet inhibition rate in control group and treatment group under adenosine diphosphate(ADP)stimulation on 2 d post-operation were(71.75±6.49)%,(65.33±5.58)%,under arachidonic acid(AA)stimulation on 2 d post-operation were(69.55±7.50)%,(62.96±7.65)%,with significant difference(P<0.05).There were myocardial infarction 1,2 cases in treatment group and control group at 1 month post-operation,recurrent angina 2,3 cases,and there was 1 case target blood vessels reascularization in control group,the incidence of ischemic events in treatment group and control group were 6.82%,13.64%.There were little bleeding 2,5 cases in treatment group and control group,slight bleeding 4,3 cases,the incidence of bleeding events in treatment group and control group were 13.64%,18.18%;There were 5,3 cases in treatment group and control group,gastrointestinal reaction 1,3 cases,arrhythmology 1,2 cases,the incidence of other adverse events in treatment group and control group were 15.91%,18.18%.There was no signi

关 键 词：替格瑞洛 氯吡格雷 不稳定型心绞痛 经皮冠状动脉介入治疗 血小板抑制 

分 类 号：R972[医药卫生—药品]