CAJ | 학술논문

目的：比较替格瑞洛与氯吡格雷在急性心肌梗死（STEMI）接受急诊冠脉介入治疗（PCI）患者中的疗效和安全性。方法选择在发病后12 h内行急诊PCI患者120例，随机分为氯吡格雷组和替格瑞洛组，观察并比较两组术后36 h的肝肾功能、肌酸激酶同工酶（CK－MB）、左室功能、血小板抑制率，随访6个月内主要不良心脑事件（MACCE）及药物不良反应发生率。结果替格瑞洛组术后36h 的 CK －MB 水平（56．5±8．3）U／L、血小板抑制率（45．9±6．4）mm，明显优于氯吡格雷组的（74．3±9．6）U／L 与（35．6±7．3）mm、（P＝0．043、0．038），在6个月的随访中，替格瑞洛组心绞痛发生率（1．7％）明显低于氯吡格雷组（6.7％）（P＝0．042），两组药物不良反应发生率差异无统计学意义（P＞0．05）。结论在STEMI 患者急诊PCI中应用替格瑞洛治疗较氯吡格雷能够显著抑制血小板，减少MACCE，改善预后。
목적：비교체격서락여록필격뢰재급성심기경사（STEMI）접수급진관맥개입치료（PCI）환자중적료효화안전성。방법선택재발병후12 h내행급진PCI환자120례，수궤분위록필격뢰조화체격서락조，관찰병비교량조술후36 h적간신공능、기산격매동공매（CK－MB）、좌실공능、혈소판억제솔，수방6개월내주요불양심뇌사건（MACCE）급약물불량반응발생솔。결과체격서락조술후36h 적 CK －MB 수평（56．5±8．3）U／L、혈소판억제솔（45．9±6．4）mm，명현우우록필격뢰조적（74．3±9．6）U／L 여（35．6±7．3）mm、（P＝0．043、0．038），재6개월적수방중，체격서락조심교통발생솔（1．7％）명현저우록필격뢰조（6.7％）（P＝0．042），량조약물불량반응발생솔차이무통계학의의（P＞0．05）。결론재STEMI 환자급진PCI중응용체격서락치료교록필격뢰능구현저억제혈소판，감소MACCE，개선예후。
Objective To compare the effects of ticagrelor and clopidogrel on patients undergoing percutane-ous coronary intervention(PCI)with acute ST elevated myocardial infarction (STEMI).Methods 120 patients with STEMI received PCI within 12h of symptom onset in our hospital were randomly divided into clopidogrel treated group (n=60)and ticagrelor treated group (n=60).Serum was collected before surgery and 36 hours after PCI for ALT, Cr,CK-MB,and MA.Cardiac ultrasound was examined,too.All patients were followed 6 months post-PCI for main adverse cardiovascular and cerebrovascular events (MACCE)and medicine side effect.Results No significantly difference was noted in baseline between the two groups.The level of CK-MB and MA in the ticagrelor treated group [CK-MB(56.5 ±8.3)U/L,MA (45.9 ±6.4)mm[and clopidogrel treated group[CK-MB(74.3 ±9.6)U/L,MA (35.6 ±7.3)mm]were significant difference (CK-MB,P=0.043;MA,P=0.038).The MACCE of patients in ticagrelor treated group were significantly lower than patients in clopidogrel treated group during post-PCI 6 months follow-up(The ratio of angina in ticagrelor group was 1.7%,while in clopidogrel group was 6.7%,P=0.042). Conclusion Ticagrelor is more effective in suppress the function of platelet,decrease MACCE in patients with STE-MI undergoing PCI.