不同剂量替格瑞洛在老年女性急性心肌梗死急诊介入治疗术后应用的疗效及安全性观察  

Efficacy and safety of different doses of ticagrelor in elderly women with acute myocardial infarction after primary PCI

作　　者：王辉[1] 杨宁 刘迎午[1] 李玉明 Wang Hui;Yang Ning;Liu Yingwu;Li Yuming(The Third Central Clinical College of Tianjin Medical University,Tianjin 300170,China)

机构地区：[1]天津医科大学三中心临床学院天津市重症疾病体外生命支持重点实验室天津市人工细胞工程技术研究中心天津市肝胆疾病研究所,300170 [2]泰达国际心血管病医院心内科

出　　处：《中华老年心脑血管病杂志》2022年第9期905-907,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：中华心血管病学发展专项基金(Z-2019-42-1908)。

摘　　要：目的 探讨不同剂量替格瑞洛在老年女性急性心肌梗死急诊PCI应用的疗效及安全性。方法 选择2018年1月~2020年6月在天津市第三中心医院心脏中心进行急诊PCI的老年女性急性心肌梗死患者120例,根据剂量不同随机分为低剂量组62例和常规剂量组58例。2组PCI术后均给予口服阿司匹林肠溶片100 mg/d序贯治疗,低剂量组给予替格瑞洛45 mg 2次/d,常规剂量组给予替格瑞洛90 mg 2次/d,记录2组二磷酸腺苷(ADP)诱导的血小板聚集率、院内主要不良心血管事件(MACE)及出血事件发生率。结果 低剂量组治疗后ADP诱导的血小板聚集率明显高于常规剂量组[(18.1±5.6)%vs(10.8±5.3)%,P<0.05]。低剂量组随访1年小出血和总出血发生率明显低于常规剂量组(12.9%vs 27.6%,P=0.019;14.5%vs 31.0%,P=0.018)。结论 老年女性急性心肌梗死急诊PCI术后应用低剂量替格瑞洛可明显抑制ADP诱导的血小板聚集,不增加MACE发生,同时可降低出血事件风险。Objective To investigate the efficacy and safety of different doses of ticagrelor for elderly female patients with acute myocardial infarction(AMI) after primary percutaneous coronary intervention(PCI).Methods A total of 120 elderly female AMI patients who underwent primary PCI in the Heart Center of Tianjin Third Central Hospital from January 2018 to June 2020 were recruited in this study.Then they were randomly divided into low-dose group(n=62) and conventional dose group(n=58) according to different doses of ticagrelor.After PCI,all the patients were given sequential treatment with oral aspirin enteric coated tablets(100 mg/d),and those from the low-dose group were given ticagrelor 45 mg/time, twice a day, while those of the other group were given ticagrelor 90 mg/time, twice a day.The platelet aggregation rate induced by adenosine diphosphate(ADP),and the incidences of major adverse cardiovascular events(MACE) and bleeding events were recorded in the 2 groups.Results The ADP-induced platelet aggregation rate was significantly higher in the low-dose group than the conventional dose group after treatment [(18.1±5.6)% vs(10.8±5.3)%,P<0.05].The incidences of minor bleeding and total bleeding were obviously lower in the low-dose group than the other group(12.9% vs 27.6%,P=0.019;14.5% vs 31.0%,P=0.018).Conclusion Low-dose ticagrelor after primary PCI can significantly inhibit ADP-induced platelet aggregation, have no effect on the incidence of MACE,and reduce the risk of bleeding events in the elderly AMI women.

关 键 词：心肌梗死 经皮冠状动脉介入治疗 阿司匹林 血小板聚集 

分 类 号：R542.22[医药卫生—心血管疾病]