不同剂量替格瑞洛治疗稳定型冠心病的临床疗效及安全性比较  

Comparative study of clinical effect and safety of different dose of ticagrelor in the treatment of stable coronary heart disease

作　　者：白星辉 王海华 BAI Xinghui;WANG Haihua(Department of Cardiovascular Internal Medicine,Leping City Traditional Chinese Medicine Hospital,Leping 333300,China)

机构地区：[1]江西省乐平市中医医院心血管内科,333300

出　　处：《临床合理用药杂志》2022年第21期4-7,共4页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的比较低剂量与高剂量替格瑞洛治疗稳定型冠心病的临床疗效及安全性。方法回顾性选取2019年1月—2021年1月乐平市中医医院收治的稳定型冠心病患者70例,根据替格瑞洛用药剂量分为低剂量组、高剂量组,各35例。患者均予以阿司匹林,其中低剂量组予以替格瑞洛45 mg/次,高剂量组予以替格瑞洛90 mg/次,2组均治疗6个月。比较2组临床疗效,治疗前后凝血功能指标[凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血酶时间(APTT)、纤维蛋白原(FIB)]、血小板功能指标[血小板最大聚集率、血小板二磷酸腺苷(ADP)抑制率]、炎性因子[肿瘤坏死因子α(TNF-α)、白介素6(IL-6)、C反应蛋白(CRP)]水平及不良反应。结果低剂量组、高剂量组总有效率分别为91.43%、94.29%,2组比较差异无统计学意义(P=1.000)。治疗前及治疗后,2组TT、PT、APTT、FIB、血小板最大聚集率、血小板ADP抑制率比较,差异无统计学意义(P>0.05);治疗后,2组TT、PT、APTT长于治疗前,血小板ADP抑制率高于治疗前,FIB、血小板最大聚集率低于治疗前(P<0.05)。治疗后,2组血清TNF-α、IL-6、CRP水平低于治疗前,且低剂量组低于高剂量组(P<0.01)。低剂量组、高剂量组不良反应总发生率分别为2.86%、8.57%,2组比较差异无统计学意义(χ^(2)=0.265,P=0.607)。低剂量组不良心血管事件发生率为2.86%,低于高剂量组的34.29%(χ^(2)=11.430,P<0.001)。结论低剂量与高剂量替格瑞洛治疗稳定型冠心病的临床疗效相当,具有类似的抗血小板聚集效果,但低剂量给药能更有效地减轻患者炎性反应,降低不良心血管事件发生率,安全性较高。Objective To compare the clinical effect and safety of different dose of ticagrelor in the treatment of stable coronary heart disease.Methods A total of 70 cases of stable coronary heart disease were selected from January 2019 to January 2021 in Leping City Traditional Chinese Medicine Hospital,and they were divided into low-dose group and high-dose group,35 cases in each group.Patients were given aspirin,and low-dose group were given ticagrelor with 45 mg at a time,high-dose group were given ticagrelor with 90 mg at a time,both groups were treated for 6 months.Clinical effect,coagulation function indexes(TT,PT,APTT,FIB),platelet function indexes(maximum platelet aggregation rate,platelet ADP inhibition rate),inflammatory factors(TNF-α,IL-6,CRP)levels,incidence of adverse reactions and unconscionable vascular events were compared between the two groups.Results There was no significant difference of the total effective rate of low-dose group(91.43%)and high-dose group(94.29%)(P=1.000).Before and after treatment,there was no significant difference of TT,PT,APTT,FIB,maximum platelet aggregation rate,platelet ADP inhibition rate between the two groups(P>0.05);after treatment,TT,PT,APTT in the two groups were longer than those before treatment,platelet ADP inhibition rate were higher than those before treatment,FIB,maximum platelet aggregation rate was lower than that before treatment(P<0.05).After treatment,serum levels of TNF-α,IL-6,CRP in the two groups were lower than those before treatment,and the low-dose group were lower than those in high-dose group(P<0.01).There was no significant difference of incidence of adverse reactions between the low-dose group(2.86%)and high-dose group(8.57%)(χ^(2)=0.265,P=0.607).Incidence of unconscionable vascular events in low-dose group was 2.86%,lower than 34.29%of high-dose group(χ^(2)=11.430,P<0.001).Conclusion Low-dose and high-dose tegrellor has equivalent effect in the treatment of stable coronary heart disease,and it has similar anti-platelet aggregation effect,but low-

关 键 词：稳定型冠心病 替格瑞洛 低剂量 高剂量 血小板功能 炎性反应 不良反应 不良心血管事件 

分 类 号：R541.4[医药卫生—心血管疾病]