摘要
目的探讨替格瑞洛对急性冠脉综合征(ACS)患者经皮冠状动脉介入治疗(PCI)后血小板功能的影响及安全性。方法选取新疆维吾尔自治区人民医院在2015年3月-2016年8月收治的经PCI治疗的ACS患者98例,按照随机数字表法分为观察组和对照组,各49例。对照组给予阿司匹林+氯吡格雷治疗,观察组给予阿司匹林+替格瑞洛治疗,2组均观察治疗12个月,分别于术前、术后24h、7d、28d检测2组患者血小板最大聚集率(MPAR)、P2Y12反应单位(PRU)、血小板内血管扩张剂刺激磷蛋白(VASP)磷酸化水平,计算血小板反应指数(PRI)。随访12个月,记录2组患者出现的主要不良心血管事件(MACE)和出血事件发生情况。结果 (1)术后24h、7d、28d观察组MPAR及PRU均显著低于对照组,差异具有统计学意义(P<0.05)。(2)术后24h、7d、28d观察组PRI水平明显低于对照组,且PRI≥50%例数明显低于对照组,差异均具有统计学意义(P<0.05)。(3)随访12个月,观察组不良心血管事件(MACE)发生率(10.20%)明显低于对照组(24.49%),差异具有统计学意义(χ2=8.440,P<0.05);观察组主要出血事件发生率低于对照组,次要出血事件发生率高于对照组,差异无统计学意义(P>0.05)。结论 ACS患者PCI术后应用替格瑞洛比氯吡格雷对血小板的拮抗作用更佳,能够降低MACE发生率,且不增加出血事件发生率。
Objective To investigate the effect and the safety of ticagrelor on platelet function after percutaneous coronary intervention（PCI）in patients with acute coronary syndrome（ACS）.Methods A total of98 ACS patients undergoing PCI from March 2015 to August 2016 in our hospital were selected and divided into observation group and control group by the random number table method,49 cases in each group.The control group was given aspirin plus clopidogrel gray treatment and observation group were treated with aspirin plus ticagrelor.Both groups were observed for 12 months.The MPAR,MPAR,P2 Y12 response unit（PRU）and platelet-derived vasodilator phospholamban（VASP）phosphorylation,and calculate the platelet response index（PRI）.The patients were followed up for 12 months.The incidence of major adverse cardiovascular events（MACE）and bleeding events.Results（1）The levels of MPAR and PRU in the observation group were significantly lower than those in the control group at 24 h,7 d,and 28 dafter operation（P 0.05）.（2）The level of PRI in observation group was significantly lower than that in control group 24 h,7 dand 28 dafter operation,and the number of cases with PRI（≥50%）was significantly lower than that in control group（P 0.05）.（3）After 12 months of follow-up,the incidence of adverse cardiovascular events（MACE）in the observation group（10.20%）was significantly lower than that of the control group（24.49%）.The difference was statistically significant（χ2=8.440,P 0.05）.The incidence of major bleeding events in the observation group was lower than that of the control group,and the incidence of secondary bleeding events was higher than that of the control group,and the difference was not statistically significant（P 0.05）.Conclusion Ticagrelor in patients with ACS has better antagonistic effect on platelets than clopidogrel,and can reduce the incidence of MACE without increasing the incidence of bleeding.
作者
成娜
单梓梅
朱佳
姬佳妮
黄榕
CHENG Na;SHAN Zimei;ZHU Jia;JI Jiani;HUANG Rong(The Third Department of Health Care for Cadres,People＇s Hospital of Xinjiang Autonomous Region,Urumqi 830001,China)
出处
《新疆医科大学学报》
CAS
2018年第9期1075-1079,共5页
Journal of Xinjiang Medical University
基金
新疆维吾尔自治区自然科学基金联合基金(2017D01C107)
新疆维吾尔自治区人民医院院内项目(20170321)
