临床药师干预对经皮冠状动脉介入术后老年患者使用替格瑞洛的疗效与安全性的影响  

Influence of clinical pharmacists’intervention on the efficacy and safety of the use of ticagrelor in elderly patients after percutaneous coronary intervention

作　　者：李志婷 李晓烨 冯六六[3] 李应敏 陈蔚[1] LI Zhiting;LI Xiaoye;FENG Liuliu;LI Yingmin;CHEN Wei(Department of Pharmacy,Shidong Hospital of Shanghai Yangpu District,Shanghai 200438,China;Department of Pharmacy,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Department of Cardiovasology,Shidong Hospital of Shanghai Yangpu District,Shanghai 200438,China)

机构地区：[1]上海市杨浦区市东医院药剂科,上海200438 [2]复旦大学附属中山医院药剂科,上海200032 [3]上海市杨浦区市东医院心血管内科,上海200438

出　　处：《药学服务与研究》2021年第5期338-341,346,共5页Pharmaceutical Care and Research

基　　金：上海市卫生和计划生育委员会科研课题(201540298)。

摘　　要：目的:探讨临床药师干预对经皮冠状动脉介入(percutaneous coronary intervention,PCI)术后老年患者使用替格瑞洛的疗效与安全性的影响。方法:选取上海市杨浦区市东医院2019年3-12月心血管内科PCI术后使用替格瑞洛治疗的127例老年患者为研究对象,按照随机序列法分为干预组(n=65)和对照组(n=62)。干预组患者由临床药师在PCI术后和出院前给予替格瑞洛用药教育和指导,并在出院后的随访中加强教育;对照组由医师或护士进行常规出院用药宣教。比较两组患者在PCI术后1个月、3个月、6个月以及1年内的心功能、出血事件及其他药品不良反应(ADRs)的发生情况。结果:两组患者在PCI术后1年内心功能及主要心血管不良事件发生情况无统计学差异(P>0.05),干预组出血事件(9.2%vs 22.6%,P=0.039)及其他ADRs发生率显著低于对照组(6.2%vs 17.7%,P=0.043)。结论:临床药师干预可减少替格瑞洛ADRs的发生,提高患者的用药安全性。Objective:To investigate the influence of clinical pharmacists’intervention on the efficacy and safety of the use of ticagrelor in elderly patients after percutaneous coronary intervention(PCI).Methods:A total of 127 elderly patients who received ticagrelor treatment after PCI in the Department of Cardiovasology from March to December 2019 were included in the study.The patients were randomly divided into the intervention group(n=65)and the control group(n=62).The patients in the intervention group received medication education and medical directions on the use of ticagrelor by clinical pharmacists both after PCI and before discharge from hospital,while the patients in the control group just received routine medication education by physicians or nurses.The cardiac function,bleeding events and other adverse drug reactions(ADRs)were compared between the patients in the two groups,1,3,6 months and 1 year after PCI.Results:There was no statistical significance in cardiac function and major adverse cardiac events(MACE)one year after PCI,when comparisons were made between the two groups(P>0.05).The incidence of bleeding events in the observation group was obviously lower(9.2%vs 22.6%,P=0.039)and the rates of other ADRs in the intervention group was also significantly lower than that in the control group(6.2%vs 17.7%,P=0.043).Conclusion:Clinical pharmacists’intervention could reduce the incidence of ADRs of ticagrelor and improve medication safety.

关 键 词：药学服务 替格瑞洛 疗效 安全性 临床药师 经皮冠状动脉介入 

分 类 号：R973.2[医药卫生—药品] R969.3[医药卫生—药学]