不同抗血小板药物对冠心病合并高同型半胱氨酸血症的疗效及安全性  

Efficacy and safety of different antiplatelet drugs on coronary heart disease with hyperhomocysteinemia

作　　者：成杰 曾建平[1,2] 彭斌 易丽青[1,2] Cheng Jie;Zeng Jianping;Peng Bin;Yi Liqing(Graduate School of Nanhua University,Hengyang 421001,China;Department of Cardiovascular Medicine,Xiangtan Central Hospital,Xiangtan 411100,China)

机构地区：[1]南华大学研究生院,衡阳421001 [2]湖南省湘潭市中心医院心血管内科,411100

出　　处：《中国医师杂志》2021年第5期729-733,共5页Journal of Chinese Physician

摘　　要：目的研究替格瑞洛与氯吡格雷对冠状动脉粥样硬化性心脏病(CHD)合并高同型半胱氨酸血症(Hhcy)患者的疗效与安全性。方法回顾性纳入101例CHD合并Hhcy且已成功行经皮冠状动脉介入治疗(PCI)的患者,根据使用抗血小板药物的不同分为替格瑞洛组(n=49)和氯吡格雷组(n=52)。收集两组临床资料,比较两组1年内主要心脑血管不良事件(MACCE)、出血事件发生率。结果两组间一般基线资料及PCI情况差异均无统计学意义(P>0.05)。与氯吡格雷组比较,替格瑞洛组能显著降低1年内总的MACCE事件(8.16%vs 32.69%,P<0.05)和不稳定型心绞痛发生率(0 vs 13.46%,P<0.05);两组间缺血性卒中、再发心肌梗死、再次血运重建、心源性死亡事件发生率比较,差异无统计学意义(P>0.05)。两组间大出血、次要出血及最小出血事件发生率比较,差异无统计学意义(4.08%vs 0;4.08%vs 1.92%;20.41%vs 9.62%;P>0.05)。结论在CHD合并Hhcy患者中,替格瑞洛可以发挥更佳的抗栓作用,明显降低缺血事件发生率且安全性好,更值得临床推荐。Objective To investigate the efficacy and safety of ticagrelor and clopidogrel in patients with coronary atherosclerotic heart disease(CHD)and hyperhomocysteinemia(Hhcy).Methods A total of 101 patients with CHD complicated with HHcy who had successfully undergone percutaneous coronary intervention(PCI)were enrolled.They were divided into ticagrelor group(n=49)and clopidogrel group(n=52)according to the different antiplatelet drugs used.The clinical data of the two groups were collected,and the incidence of major cardiovascular and cerebrovascular adverse events(MACCE)and bleeding events in one year were compared between the two groups.Results There was no statistical difference in baseline datas and PCI datas between the clopidogrel and ticagrelor groups(P>0.05).Compared with clopidogrel group,ticagrelor can reduce the total MACCE(8.16%vs 32.69%,P<0.05)and the incidence of unstable angina pectoris events(0 vs 13.46%,P<0.05)in patients with hyperhomocysteinemia PCI 1 year after operation.The incidences of ischemic stroke,unstable angina pectoris,recurrent myocardial infarction,and cardiogenic death were compared separately between the two groups,and the difference was not statistically significant(P>0.05).The incidence of major bleeding events,minor bleeding events,and minimal bleeding events were similar between the two groups,and the difference was not statistically significant(4.08%vs 0;4.08%vs 1.92%;20.41%vs 9.62%;P>0.05).Conclusions In patients with CHD and Hhcy,ticagrelor can play a better antithrombotic effect,reduce the incidence of ischemic events,and has good security,which is more worthy of clinical recommendation.

关 键 词：冠状动脉疾病 高同种半胱氨酸血症 替格瑞洛 氯吡格雷 经皮冠状动脉介入治疗 

分 类 号：R541.4[医药卫生—心血管疾病]