山东医药
山東醫藥
산동의약
SHANDONG MEDICAL JOURNAL
2014年
36期
1-3,7
,共4页
急性心肌梗死%替格瑞洛%氯吡格雷%安全性%有效性
急性心肌梗死%替格瑞洛%氯吡格雷%安全性%有效性
급성심기경사%체격서락%록필격뢰%안전성%유효성
acute myocardial infarction%ticagrelor%clopidogrel%safety%efficacy
目的:探讨急性心肌梗死(AMI)患者在急诊经皮冠状动脉介入治疗(PCI)术前使用负荷剂量替格瑞洛的有效性及安全性,并与氯吡格雷进行比较。方法选取84例在发病后12 h内行急诊PCI治疗的AMI患者,随机分为氯吡格雷组40例和替格瑞洛组44例,两组患者术前1 h分别服用负荷剂量的氯吡格雷600 mg和替格瑞洛180 mg,术后两组均接受氯吡格雷75 mg、1次/d的维持治疗,观察时间为7 d,随访30 d。观察用药前及用药后0.5 h、2 h、24 h、2 d及7 d时血小板聚集率,术后TIMI血流,30 d内复合终点事件及不良反应。结果氯吡格雷组用药0.5、2、24 h血小板聚集率及不良反应总发生率分别为81.28%±9.81%、62.06%±8.80%、59.31%±13.11%和65.00%,替格瑞洛组分别为64.35%±11.46%、43.73%±6.40%、45.96%±11.90%和20.45%,P均<0.01;氯吡格雷组复合终点事件总发生率、术后血流TIMI 3级分别为2.50%、80.00%,替格瑞洛组分别为2.27%、77.27%,P均>0.05。结论 AMI患者急诊PCI术前使用负荷剂量替格瑞洛较氯吡格雷早期抑制血小板聚集作用更显著,且不增加出血,胃肠道不良反应发生率低。
目的:探討急性心肌梗死(AMI)患者在急診經皮冠狀動脈介入治療(PCI)術前使用負荷劑量替格瑞洛的有效性及安全性,併與氯吡格雷進行比較。方法選取84例在髮病後12 h內行急診PCI治療的AMI患者,隨機分為氯吡格雷組40例和替格瑞洛組44例,兩組患者術前1 h分彆服用負荷劑量的氯吡格雷600 mg和替格瑞洛180 mg,術後兩組均接受氯吡格雷75 mg、1次/d的維持治療,觀察時間為7 d,隨訪30 d。觀察用藥前及用藥後0.5 h、2 h、24 h、2 d及7 d時血小闆聚集率,術後TIMI血流,30 d內複閤終點事件及不良反應。結果氯吡格雷組用藥0.5、2、24 h血小闆聚集率及不良反應總髮生率分彆為81.28%±9.81%、62.06%±8.80%、59.31%±13.11%和65.00%,替格瑞洛組分彆為64.35%±11.46%、43.73%±6.40%、45.96%±11.90%和20.45%,P均<0.01;氯吡格雷組複閤終點事件總髮生率、術後血流TIMI 3級分彆為2.50%、80.00%,替格瑞洛組分彆為2.27%、77.27%,P均>0.05。結論 AMI患者急診PCI術前使用負荷劑量替格瑞洛較氯吡格雷早期抑製血小闆聚集作用更顯著,且不增加齣血,胃腸道不良反應髮生率低。
목적:탐토급성심기경사(AMI)환자재급진경피관상동맥개입치료(PCI)술전사용부하제량체격서락적유효성급안전성,병여록필격뢰진행비교。방법선취84례재발병후12 h내행급진PCI치료적AMI환자,수궤분위록필격뢰조40례화체격서락조44례,량조환자술전1 h분별복용부하제량적록필격뢰600 mg화체격서락180 mg,술후량조균접수록필격뢰75 mg、1차/d적유지치료,관찰시간위7 d,수방30 d。관찰용약전급용약후0.5 h、2 h、24 h、2 d급7 d시혈소판취집솔,술후TIMI혈류,30 d내복합종점사건급불량반응。결과록필격뢰조용약0.5、2、24 h혈소판취집솔급불량반응총발생솔분별위81.28%±9.81%、62.06%±8.80%、59.31%±13.11%화65.00%,체격서락조분별위64.35%±11.46%、43.73%±6.40%、45.96%±11.90%화20.45%,P균<0.01;록필격뢰조복합종점사건총발생솔、술후혈류TIMI 3급분별위2.50%、80.00%,체격서락조분별위2.27%、77.27%,P균>0.05。결론 AMI환자급진PCI술전사용부하제량체격서락교록필격뢰조기억제혈소판취집작용경현저,차불증가출혈,위장도불량반응발생솔저。
Objective To explore the safety and efficacy of loading dose of ticagrelor and clopidogrel before percuta -neous coronary intervention (PCI) in patients with emergency acute myocardial infarction (AMI).Methods Eighty-four emergency AMI patients treated with emergency PCI in 12 hours, who were randomly divided into clopidogrel group (40 ca-ses, 600 mg loading dose) and ticagrelor group (44 cases, 180 mg loading dose) in one hour before PCI.Two groups fol-lowed by 75 mg daily thereafter.Observation time was 7 d, follow-up time was 30 d.To observe the platelet aggregation rate and postoperative TIMI flow before treatment , medication 0.5 h, 2 h, 24 h, 2 d and 7 d, and the composite endpoint and adverse events within 30 d.Results In clopidogrel group , the platelet aggregation rate in medication of 0.5 h, 2 h, 24 h was 81.28%±9.81%, 62.06%±8.80%, 59.31%±13.11%, the overall incidence of adverse reactions was 65.00%;ticagrelor group was 64.35%±11.46%, 43.73%±6.40%, 45.96%±11.90%and 20.45%;all P<0.01. Clopidogrel overall incidence of the composite endpoint events , postoperative TIMI 3 flow grade were 2.50%, 80.00%;ti-cagrelor group were 2.27%, 77.27%;both P>0.05.Conclusion Emergency AMI patients before PCI using a loading dose of ticagrelor had more significant role in the early inhibition of platelet compared with clopidogrel , and without increas-ing bleeding , lower incidence of the gastrointestinal reactions .