2018 年第 2 期 第 13 卷

冠状动脉介入治疗患者口服替格瑞洛的疗效观察

作者：鄂璐莎

英文作者：

单位：010017呼和浩特，内蒙古自治区人民医院心内科

英文单位：

关键词：冠状动脉介入；替格瑞洛；氯吡格雷

英文关键词：

• 摘要：

• 目的    探讨接受冠状动脉介入治疗患者口服替格瑞洛的临床疗效及安全性。方法    选取2014年4月至2016月4月在内蒙古自治区人民医院接受冠状动脉介入治疗的110例患者为研究对象，应用随机数字表法分为2组，对照组55例在冠状动脉介入术前给予氯吡格雷300 mg联合阿司匹林300 mg口服，术后给予氯吡格雷75 mg联合阿司匹林100 mg，1次/d口服；观察组55例在介入术前给予替格瑞洛180 mg联合阿司匹林300 mg口服，术后给予替格瑞洛90 mg、2次/d联合阿司匹林100 mg、1次/d口服，连续1个月。观察2组患者介入前后血小板聚集率和心功能的变化，以及介入后12个月内心血管不良事件和出血事件的发生情况。结果    介入治疗前2组血小板聚集率比较差异无统计学意义（P>0.05），介入后24 h和6个月2组血小板聚集率均低于本组介入治疗前［观察组：（57±4）%、（40±3）%比（86±4）%，对照组：（61±4）%、（44±3）%比（86±4）%］,且观察组低于对照组，差异均有统计学意义（均P＜0.05）。2组患者介入治疗前左心室射血分数和左心室舒张末期内径比较差异无统计学意义（均P>0.05），介入后6个月2组左心室射血分数均高于介入治疗前、且观察组高于对照组，介入后6个月2组左心室舒张末期内径均低于治疗前、且观察组低于对照组，差异均有统计学意义（均P＜0.05）。观察组术后12个月内再发心肌梗死1例，出血1例；对照组再发心肌梗死2例，支架血栓2例，出血2例，心绞痛1例，观察组心血管不良事件发生率低于对照组［3.6%（2/55）比12.7%（7/55）］,差异有统计学意义（χ2=4.369，P=0.041）。结论    接受冠状动脉介入治疗患者口服替格瑞洛，无论从安全性还是心血管获益方面均优于氯吡格雷。

• Effect of ticagrelor on patients undergoing percutaneous coronary intervention

  E Lusha

  Department of Cardiology, Inner Mongolia People′s Hospital, Hohhot 010017, China, Email: elusha2008@126.com

  【Abstract】Objective    To investigate the clinical efficacy and safety of ticagrelor in treating patients undergoing percutaneous coronary intervention. Methods    Totally 110 patients undergoing percutaneous coronary intervention from April 2014 to April 2016 in Inner Mongolia People′s Hospital were randomly divided into control group and observation group, with 55 cases in each group. Patients in control group took 300 mg clopidogrel and 300 mg aspirin before coronary intervention, and they took 75 mg clopidogrel and 100 mg aspirin（1 time/d） after operation. Patients in control group took 180 mg ticagrelor and 300 mg aspirin before operation, and they took 90 mg ticagrelor（2 times/d） and 100 mg aspirin（1 time/d） after operation. The course of treatment was 1 month. Platelet aggregation rate and heart function were detected before and after operation. Occurrences of cardiovascular events and bleeding were observed during 12 months after operation. Results    Platelet aggregation rate had no significant difference between groups before operation(P>0.05). At 24 h and 6 months after operation, platelet aggregation rate was significantly lower than that before operation in both groups［observation group： （57±4）%,（40±3）% vs （86±4）%; control group： （61±4）%,（44±3）% vs （86±4）%］, and it was significantly lower in observation group than that in control group(P<0.05). Left ventricular ejection fraction and left ventricular end-diastolic dimension had no significant differences between groups before operation(P>0.05). After 6 months of treatment, left ventricular ejection fraction was significantly higher and left ventricular end-diastolic dimension was significantly lower than those before operation, and there were significant differences between groups（P＜0.05）. There was 1 case of recurrent myocardial infarction and 1 case of bleeding in observation group. There were 2 cases of recurrent myocardial infarction, 2 cases of stent thrombosis, 2 cases of bleeding and 1 case of angina pectoris in control group. The 12-month rate of cardiovascular events in observation group was significantly lower than that in control group［3.6%（2/55） vs 12.7%（7/55）］（χ2=4.369, P=0.041）. Conclusion    Ticagrelor is superior to clopidogrel for patients undergoing coronary intervention in terms of safety and cardiovascular benefits.

  【Key words】Coronary intervention;Ticagrelor;Clopidogrel

  【Fund program】Natural Science Foundation of Inner Mongolia Autonomous Region(2016MS0867)