替格瑞洛对急性ST段抬高型心肌梗死患者行经皮冠状动脉介入术的疗效及安全性  

Clinical efficacy and safety of ticagrelor, a new antiplatelet agent P2Y12, in patients with acute ST segment elevation myocardial infarction underwent emergency PCI

作　　者：王静[1] 彭永平[1] 宫剑滨[1] 刘挺松[1] 王磊[1] 侯丽丽[1] 

机构地区：[1]210002,南京军区南京总医院心脏内科

出　　处：《中国综合临床》2015年第8期-,共4页Clinical Medicine of China

摘　　要：目的 探讨替格瑞洛在急性ST段抬高型心肌梗死(STEMI)患者直接经皮冠状动脉介入(PCI)治疗中的临床疗效及安全性.方法 2013年1月至2014年7月我院心脏内科收治的174例接受急诊PCI的STEMI死患者,随机分为氯吡格雷组88例(术前顿服氯吡格雷600 mg)和替格瑞洛组86例(术前顿服替格瑞洛180 mg).比较两组血小板抑制率,术前、术后肾功能,术后30 d主要临床心血管事件及出血事件,药物不良反应情况.结果 (1)两组患者花生四烯酸途径抑制率相比,差异无统计学意义(P＞0.05);两组患者二磷酸腺苷途径抑制率相比,替格瑞洛组(71.82±19.97)％明显升高,且高于氯吡格雷组(38.96±27.55)％,差异有统计学意义(t=-7.569,P＜0.001).(2)两组主要心血管事件相比,替格瑞洛组(5例)较氯吡格雷组(15例)减少,两组间比较差异有统计学意义(P=0.02);两组出血事件相比,替格瑞洛组(15例)与氯吡格雷组(11例)之间比较差异无统计学意义(P=0.617).结论 替格瑞洛在急性STEMI患者直接PCI治疗中的效果优于氯吡格雷,可减少患者心血管事件风险,且不增加严重出血.Objective To observe the clinical efficacy and safety of ticagrelor,a new antiplatelet agent,in patients with ST-Segment elevation myocardial infarction (STEMI) underwent emergency PCI.Methods Selected 174 patients with STEMI receiving emergency PCI treatment from January 2013 to July 2014 in Nanjing General Hospital of Nanjing Military Area Command,and randomly divided into clopidogrel group (preoperative taking 600 mg of clopidogrel,n =88) and ticagrelor group (preoperative taking 180 mg of ticagrelor,n =86).Compared platelet inhibition rate,renal function before and after treatment,major clinical cardiovascular events and bleeding events 30 d after treatment,adverse drug reactions of two groups.Results (1) Arachidonic acid pathway inhibition rate of the two groups were compared,the difference was not statistically significant (P ＞0.05).Compared two groups of patients with adenosine phosphate pathway inhibition rate,ticagrelor group was higher,the difference was statistically significant ((71.82 ± 19.97) ％ vs.(38.96 ± 27.55) ％;t =-7.569,P ＜0.001).(2) Compared major cardiovascular events of ticagrelor group(5 cases) and clopidogrel group (15 cases),ticagrelor group was decreased.There was significant differences (P =0.02) between the two groups.Bleeding events compared to between ticagrelor group (15 cases) and clopidogrel group (11 cases),no statistically significant difference was found(P =0.617).Conclusion Clinical efficacy of ticagrelor in acute ST-segment elevation myocardial infarction treated with primary PCI is superior to clopidogrel in which can reduce the risk of cardiovascular events in patients and without an increase in severe bleeding.

关 键 词：ST段抬高型心肌梗死 急诊经皮冠状动脉介入 替格瑞洛 

分 类 号：R5[医药卫生—内科学]