ACS合并糖尿病使用替格瑞洛的有效性和安全性评价  

Efficacy and safety of ticagrelor in patients with acute coronary syndrome and diabetes

作　　者：王宇[1] 徐颖颖[1] 蔡鑫君[1] 郑韧 金洁 李金梦 江欢欢[1] 袁媛 WANG Yu;XU Yingying;CAI Xinjun;ZHENG Ren;JIN Jie;LI Jinmeng;JIANG Huanhuan;YUAN Yuan(Department of Pharmaceutical,Zhejiang Hospital of Integrated Traditional Chinese and Western Medicine,Zhejiang,Hangzhou 310006,China)

机构地区：[1]浙江省中西医结合医院药学部,浙江杭州310006

出　　处：《中国现代医生》2022年第32期80-82,99,共4页China Modern Doctor

基　　金：杭州市生物医药健康产业发展扶持科研专项(2022WJC051)。

摘　　要：目的探讨急性冠脉综合征(acute coronary syndrome,ACS)合并糖尿病患者使用替格瑞洛后的有效性及安全性情况。方法回顾性分析2020年3月至2022年3月浙江省中西医结合医院收治的ACS合并糖尿病患者60例,心内科介入医生对患者的个体情况、病变复杂程度、残余SYNTAX评分和CRUSADE出血评分等因素进行评估,权衡缺血与出血风险,将其分为氯吡格雷组(n=35)和替格瑞洛组(n=25)。两组患者在经皮冠脉介入术(percutaneous coronary intervention,PCI)治疗后均服用阿司匹林100mg。氯吡格雷组患者服用氯吡格雷75mg,1次/d;替格瑞洛组患者首次用药负荷量180mg,次日开始90mg,2次/d。随访6个月进行治疗有效性及安全性评价。结果相比氯吡格雷,替格瑞洛可以有效减少患者住院天数,减少患者再次入院和再发支架内狭窄或再发心肌梗死发生率,对血糖波动影响较小。结论在ACS合并糖尿病患者中使用替格瑞洛,可弥补氯吡格雷起效慢、个体疗效差异大等不足,使患者有更大获益。Objective To investigate the effectiveness and safety profile of ticagrelor in patients with acute coronary syndrome(ACS)complicated with diabetes mellitus.Methods To analyze 60 patients with ACS and diabetes after percutaneous coronary intervention(PCI)in Zhejiang Hospital of Integrated Traditional Chinese and Western Medicine from March 2020 to March 2022 retrospectively.The interventional cardiologists assessed the individual patient,the complexity of the lesion,the residual SYNTAX score and the CRUSADE bleeding score,weighing the risk of ischaemia versus bleeding,and divided them into clopidogrel group(n=35)and tegretol group(n=25).Patients in both groups were given aspirin 100mg after PCI treatment.The clopidogrel group took clopidogrel 75mg once a day,the patients taking ticagrelor received an initial loading dose of 180mg,followed by 90mg the next day,twice a day.To evaluate the efficacy,endpoint and safety after 6-month follow-up study.Results Compared with clopidogrel,ticagrelor can effectively reduce the length of stay,and the number of readmission,recurrent in-stent stenosis or recurrent myocardial infarction,and meanwhile,it has less impact on glycemic fluctuation.Conclusion Compared with clopidogrel,ticagrelor makes up for the shortcomings of slow onset of action and large differences in individual curative effect in patients with ACS complicated with diabetes mellitus,bringing greater benefits for patients.

关 键 词：替格瑞洛 氯吡格雷 急性冠脉综合征 糖尿病 经皮冠状动脉介入治疗 

分 类 号：R969.3[医药卫生—药理学]