| 摘要: |
| ［摘要］ 目的 评价急性ST段抬高型心肌梗死(ST segment elevation myocardial infarction，STEMI)行急诊经皮冠状动脉介入治疗(percutaneous coronary intervention，PCI)术前给予单剂量替格瑞洛的有效性及安全性。方法 选择2015-03～2016-03该院收治的80例发病12 h以内、接受急诊PCI的急性STEMI患者为研究对象，应用随机数字量表分为替格瑞洛组40例和氯吡格雷组40例。术后12 h替格瑞洛组更换为氯吡格雷，氯吡格雷组继续维持治疗，观察并比较两组患者术后血小板计数、PCI术后2 h、6 h通过血栓弹力图检测花生四烯酸(arachidonic acid，AA）及二磷酸腺苷(adenosine diphosphate，ADP)诱导的血小板抑制率、梗死相关血管TIMI血流水平和住院期间主要不良心血管事件(major adverse cardiovascular events，MACE)及出血事件。结果 两组患者一般临床资料、冠状动脉病变特征比较差异均无统计学意义（P>0.05）。替格瑞洛组术后2 h、6 h ADP诱导的血小板抑制率高于氯吡格雷组（P<0.05）。替格瑞洛组术后梗死相关血管TIMI血流<3级者4例，氯吡格雷组13例，两组比较差异有统计学意义（P<0.05）。替格瑞洛组住院期间MACE发生率为10.0%（4/40），氯吡格雷组为12.5%（5/40），差异无统计学意义（P>0.05）。两组出血事件发生率分别为10.0%和7.5%，差异无统计学意义（P>0.05）。结论 单剂量替格瑞洛对急性STEMI患者行急诊PCI具有良好的有效性和安全性。 |
| 关键词: 替格瑞洛 抗血小板治疗 单剂量 心肌梗死 经皮冠状动脉介入治疗 |
| DOI：10.3969/j.issn.1674-3806.2017.03.12 |
| 分类号:R 54 |
| 基金项目: |
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| Evaluation on the efficacy and safety of single-dose ticagrelor on acute ST segment elevation myocardial infarction undergoing emergency percutaneous coronary intervention |
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LIU Guo-lou, PENG Yong, GAO Wen-jun, et al.
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Department of Cardiovascular Disease, the First People′s Hospital of Zhumadian, Henan 463000, China
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| Abstract: |
| ［Abstract］ Objective To evaluate the safety and efficacy of antiplatelet therapy of single-dose ticagrelor on patients suffering from acute ST segment elevation myocardial infarction(STEMI) undergoing primary percutaneous coronary intervention(PCI).Methods Eighty patients with STEMI within 12 h undergoing primary PCI from March 2015 to March 2016 were randomly divided into the ticagrelor group(n=40) and the clopidogrel group(n=40) by using the method of random number table. 12 hours after the operation, ticagrelor was replaced with clopidogrel in the ticagrelor group, while clopidogrel was used before and after the operation in the clopidogrel group. The platelet count before and after the operation, arachidonic acid(AA) and adenosine diphosphate(ADP) induced platelet inhibition rate by thrombelastograph in 2 h, 6 h after the operation, the level of TIMI blood flow of IRA and the major adverse cardiovascular events and bleeding events during hospitalization were compared between the two groups.Results There were no significant differences between the two groups in the baseline data and the features of coronary artery lesions(P>0.05). ADP induced platelet inhibition rates in 2 h and 6 h after the operation in the ticagrelor group were significantly higher than those in the clopidogrel group(P<0.05). TIMI flow less than 3 of the infarction related artery occurred in 4 cases in the ticagrelor group, while in 13 cases in the clopidogrel group, with a significant difference between the two groups(P<0.05). During the hospitalization, the major adverse cardiovascular events occurred in 4 cases in the ticagrelor group(10.0%), and in 5 cases in the clopidogrel group(12.5%)(P>0.05). There was no significant difference in the incidence of bleeding between the ticagrelor group and the clopidogrel group(10.0% vs 7.5%), P>0.05.Conclusion Antiplatelet therapy of single-dose ticagrelor is effective and safe on the patients suffering from acute STEMI and undergoing primary PCI. |
| Key words: Ticagrelor Antiplatelet therapy Single-dose Myocardial infarction Percutaneous coronary intervention(PCI) |
