低剂量替格瑞洛与氯吡格雷分别联合阿司匹林对老年冠心病患者PCI术后不良心血管事件的影响  

Effects of low-dosage ticagrelor combined with aspirin,clopidogrel combined with aspirin on adverse cardiovascular events in elderly patients with coronary heart disease after PCI

作　　者：张琮[1] 赵佩 张占海[2] Zhang Cong;Zhao Pei;Zhang Zhanhai(Department of Special Ward,the First Affiliated Hospital of Nanyang Medical College,Nanyang 473000,China;Department of Internal Medicine-Cardiovascular,the First Affiliated Hospital of Nanyang Medical College,Nanyang 473000,China)

机构地区：[1]南阳医学高等专科学校第一附属医院特需病房,河南省473000 [2]南阳医学高等专科学校第一附属医院心血管内科,河南省473000

出　　处：《中国实用医刊》2020年第11期105-109,共5页Chinese Journal of Practical Medicine

摘　　要：目的探究低剂量替格瑞洛与氯吡格雷分别联合阿司匹林对老年冠心病患者行经皮冠状动脉介入(PCI)术后不良心血管事件的影响。方法选取2017年3月至2019年3月南阳医学高等专科学校第一附属医院收治的78例行PCI术的老年冠心病患者为研究对象,将患者按随机数字表法分为对照组与研究组,每组39例。对照组患者使用氯吡格雷+阿司匹林进行治疗,研究组患者术后使用低剂量替格瑞洛+阿司匹林进行治疗,治疗3个月。比较两组治疗前、治疗后3个月血小板功能[最大血小板聚集率(PAR)、P2Y12反应单位(PRU)]和炎性反应指标[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)]、髓体过氧化物酶(MPO)、心肌损伤指标[肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白T(cTnT)],并记录用药期间不良反应及出血事件,及随访6个月期间出现的主要不良心血管事件。结果治疗后3个月,两组患者的MPAR、PRU、IL-6、TNF-α、CRP、MPO、CK-MB和cTnT均较治疗前下降(P<0.05),且研究组上述指标低于对照组(P<0.05)。治疗期间,研究组不良反应发生率为17.95%(7/39),出血事件发生率为5.13%(2/39);对照组不良反应发生率为23.08%(9/39),出血事件发生率为15.38%(6/39),两组比较差异未见统计学意义(P>0.05)。随访6个月,研究组主要不良心血管事件发生率为15.38%(6/39),低于对照组的35.90%(14/39),P<0.05。结论应用低剂量替格瑞洛联合阿司匹林对老年冠心病患者PCI术后的疗效更佳,可显著降低主要不良心血管事件及出血事件,降低炎症反应,减轻心肌损伤,安全性良好,具有较高应用价值。Objective To investigate the effects of low-dosage ticagrelor combined with aspirin(ASA),clopidogrel(CLP)combined with aspirin(ASA)on adverse cardiovascular events after percutaneous coronary intervention(PCI)in elderly patients with coronary heart disease(CHD).Methods A total of 78 elderly patients with CHD who underwent PCI in the First Affiliated Hospital of Nanyang Medical College from March 2017 to March 2019 were enrolled as the study subjects.The patients were divided into control group and study group according to the random number table method,with 39 cases in each group.The control group was treated with CLP+ASA,and the study group was treated with low-dosage ticagrelor+ASA.They all were treated for 3 months.The platelet function,including maximum platelet aggregation rate(PAR),P2Y12 response unit(PRU),inflammatory response indexes,such as interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),myeloperoxidase(MPO)and myocardial injury indexes,including creatine kinase isoenzyme MB(CK-MB),cardiac troponin T(cTnT),were compared between the two groups before treatment and after 3 months of treatment.Moreover,adverse drug reactions and bleeding events,during medicine administration,and major adverse cardiovascular events(MACE)during 6 months of follow-up were recorded.Results After 3 months of treatment,the MPAR,PRU,IL-6,TNF-α,CRP,MPO,CK-MB and cTnT in the two groups significantly decreased,compared with those before treatment(P<0.05);and the above indicators in study group were significantly lower than those in control group(P<0.05).During treatment,the incidences of adverse reaction and bleeding events in the study group were 17.95%(7/39)and 5.13%(2/39),respectively;while the incidences of adverse reaction and bleeding events in the control group were 23.08%(9/39)and 15.38%(6/9),respectively;there was no significant difference in the incidence between the two groups(P>0.05).During 6 months of follow-up,the incidence of MACE in study group(15.38%,6/39)was significantly lower than tha

关 键 词：冠心病 经皮冠状动脉介入 替格瑞洛 氯吡格雷 阿司匹林 不良心血管事件 

分 类 号：R541.4[医药卫生—心血管疾病]