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分析。方法选取四川省医学科学院四川省人民医院于2015年3月~2016年8月收治的接受PCI治疗的ACS患者98例,随机分为观察组和对照组,每组各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,两组均观察12个月;分别于术前、术后24 h、7 d、28 d检测两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,记录两组患者出现主要不良心血管事件(MACE)和出血事件发生情况。结果 (1)术后24 h、7 d、28 d观察组MPAR、PRU水平明显低于对照组,差异具有统计学意义(P均<0.05);(2)术后24 h、7 d、28 d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,差异具有统计学意义(P均<0.05);(3)随访1年,观察组MACE发生率明显低于对照组(10.20%vs.34.69%),差异具有统计学意义(P<0.05);观察组主要出血事件低于对照组,次要出血事件高于对照组,差异无统计学意义(P>0.05)。结论 ACS患者术后应用替格瑞洛治疗相比于氯吡格雷对血小板拮抗作用更佳,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 of 98 ACS patients undergoing PCI from March 2015 to August 2016 were selected and divided into observation group and control group according to the random number table method.Each group had 49 patients.The control group was given aspirin plus clopidogrel,and the observation group were treated with aspirin+ticagrelor.Both groups were observed for 12 months.The maximum platelet aggregation rate(MPAR),P2Y12 response unit(PRU),vasodilator stimulated phosphoprotein(VASP)phosphorylation,and the platelet response index(PRI)were measured.The patients were followed up for 12 months.The incidence of major adverse cardiovascular events(MACE)and bleeding events were recorded.Results(1)The levels of MPAR and PRU in the observation group at 24 h,7 days and 28 days after operation were significantly lower than those in the control group(P<0.05).(2)The levels of PRI in the observation group at 24 h,7 days and 28 days after operation were significantly lower than those in the control group,and the number of patients with PRI≥50%was significantly lower than that in the control group(P<0.05).(3)After one year of follow-up,the incidence of MACE in observation group was significantly lower than that in control group(10.20%vs.34.69%),the difference was statistically significant(P<0.05).The number of main bleeding cases in the observation group was lower than that in the control group,and the number of secondary bleeding cases was higher than that in the control group,the difference was not statistically significant(P>0.05).Conclusions 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
唐艺加
黄慧
周咏梅
舒燕
Tang Yijia;Huang Hui;Zhou Yongmei;Shu Yan(Department of Cardiology,Sichuan Provincial people's hospital,Sichuan academy of Medical Science,Chengdu 610072,Sichuan,China)
出处
《中国循证心血管医学杂志》
2018年第6期661-664,共4页
Chinese Journal of Evidence-Based Cardiovascular Medicine
基金
四川省卫生厅科研课题(080382)
