CAJ | 학술논문

目的：观察治疗急性冠状动脉综合征（ACS）新药替格瑞洛对急性ST段抬高型心肌梗死（STEMI）的临床疗效，并将其与氯吡格雷的疗效进行对比，以获取关于替格瑞洛在国内临床应用方面的前瞻性临床数据。 　　方法：接受替格瑞洛治疗的157例STEMI患者为研究组，给予替格瑞洛+阿司匹林治疗；150例氯吡格雷治疗的STEMI患者为对照组，给予氯吡格雷+阿司匹林治疗。治疗1个月、3个月、6个月时，对两组患者的主要不良心血管事件（MACE）发生率、血栓再形成发生率以及血常规等疗效相关的指标进行对比分析。 　　结果：研究组1、3、6个月时的MACE事件累积发生率较对照组差异无统计学意义（P>0.05）；研究组患者的左心室舒张末期半径、左心室射血分数、血小板水平、ST段回落情况等指标与对照组相比，差异具有统计学意义（P<0.05或0.01）。在不良反应方面，研究组患者的呼吸困难、出血事件发生率稍高，但并不影响治疗且不需采取特殊处理。 　　结论：替格瑞洛在改善STEMI患者的血小板水平、心功能等方面的疗效与氯吡格雷基本相近，关于其国外所报道的临床疗效优势需进一步验证。
목적：관찰치료급성관상동맥종합정（ACS）신약체격서락대급성ST단태고형심기경사（STEMI）적림상료효，병장기여록필격뢰적료효진행대비，이획취관우체격서락재국내림상응용방면적전첨성림상수거。 　　방법：접수체격서락치료적157례STEMI환자위연구조，급여체격서락+아사필림치료；150례록필격뢰치료적STEMI환자위대조조，급여록필격뢰+아사필림치료。치료1개월、3개월、6개월시，대량조환자적주요불양심혈관사건（MACE）발생솔、혈전재형성발생솔이급혈상규등료효상관적지표진행대비분석。 　　결과：연구조1、3、6개월시적MACE사건루적발생솔교대조조차이무통계학의의（P>0.05）；연구조환자적좌심실서장말기반경、좌심실사혈분수、혈소판수평、ST단회락정황등지표여대조조상비，차이구유통계학의의（P<0.05혹0.01）。재불량반응방면，연구조환자적호흡곤난、출혈사건발생솔초고，단병불영향치료차불수채취특수처리。 　　결론：체격서락재개선STEMI환자적혈소판수평、심공능등방면적료효여록필격뢰기본상근，관우기국외소보도적림상료효우세수진일보험증。
Objective: To explore the clinical efficacy of a new drug for acute coronary syndrome (ACS), ticagrelor in treating the patients with acute ST-segment elevation myocardial infarction (STEMI), and to compare the effect between ticagrelor and clopidogrel in order to obtain the prospective information of ticagrelor in clinical practice. Methods: A total of 307 STEMI patients were divided into 2 groups, Treatment group, the patients received ticagrelor with aspirin, n=157 and Control group, the patients received clopidogrel with aspirin, n=150. With a period of treatment, the major adverse cardiac events (MACE), rate of thrombosis re-formation and routine blood test result were compared between 2 groups. Results: Treatment group presented the better LVDD, LVEF, platelet level and ST-segment recovery than those in Control group, P<0.05 or P<0.01. Treatment group showed slightly higher rate of side effect such as dififcult breathing and bleeding, while those reaction did not affect the treatment or special management for the patients. Conclusion: The clinical effect of ticagrelor is similar to clopidogre for improving the platelet level and cardiac function in STEMI patients, while the clinical advantage reported in abroad should be further studied.