中国全科医学
中國全科醫學
중국전과의학
CHINESE GENERAL PRACTICE
2015年
15期
1824-1827
,共4页
李燕%王立忠%张春来%卢峰%李静%穆怀彬
李燕%王立忠%張春來%盧峰%李靜%穆懷彬
리연%왕립충%장춘래%로봉%리정%목부빈
心绞痛,不稳定型%血管成形术,气囊,冠状动脉%血小板聚集抑制剂%替格瑞洛%氯吡格雷
心絞痛,不穩定型%血管成形術,氣囊,冠狀動脈%血小闆聚集抑製劑%替格瑞洛%氯吡格雷
심교통,불은정형%혈관성형술,기낭,관상동맥%혈소판취집억제제%체격서락%록필격뢰
Angina,unstable%Angioplasty,balloon,coronary%Platelet aggregation inhibitors%Ticagrelor%Clopidogrel
目的:探讨不稳定型心绞痛患者经皮冠状动脉介入治疗(PCI)中使用替格瑞洛的疗效与安全性。方法选择2013年2月—2014年5月在唐山市工人医院择期行PCI的不稳定型心绞痛患者105例,采用随机数字表法分为A组(n=52)和B组(n=53)。两组术前、术后均给予阿司匹林,A组在此基础上加服替格瑞洛(术前负荷量180mg/次,1次/d;术后标准量90mg/次,2次/d);B组加用氯吡格雷(术前负荷量300mg/次,1次/d;术后标准量75mg/d,1次/d),疗程6个月。结果术前两组血小板P2Y12反应单位(PRU)间差异无统计学意义(P>0.05);术后24hA组PRU低于B组(P<0.05)。随访6个月,A组脑血管意外1例;B组心肌梗死1例,心力衰竭1例,脑血管意外4例;两组主要不良心血管事件(MACE)发生率比较,差异有统计学意义(χ2=3.752,P<0.05)。两组总出血事件发生率(A组主要出血1例,小出血2例,轻微出血3例;B组主要出血1例,小出血3例,轻微出血4例)间差异无统计学意义(χ2=0.287,P>0.05)。A组重度呼吸困难1例,中度1例,轻度2例;B组未见呼吸困难者。两组术后24h丙氨酸氨基转移酶(ALT)水平间差异无统计学意义(P>0.05);A组术后24h肌酐(Cr)水平高于B组(P<0.05)。结论替格瑞洛较氯吡格雷具有更好的抗血小板聚集作用,且不增加出血风险,肝肾损伤风险低,对择期行PCI不稳定型心绞痛患者的安全性较好。
目的:探討不穩定型心絞痛患者經皮冠狀動脈介入治療(PCI)中使用替格瑞洛的療效與安全性。方法選擇2013年2月—2014年5月在唐山市工人醫院擇期行PCI的不穩定型心絞痛患者105例,採用隨機數字錶法分為A組(n=52)和B組(n=53)。兩組術前、術後均給予阿司匹林,A組在此基礎上加服替格瑞洛(術前負荷量180mg/次,1次/d;術後標準量90mg/次,2次/d);B組加用氯吡格雷(術前負荷量300mg/次,1次/d;術後標準量75mg/d,1次/d),療程6箇月。結果術前兩組血小闆P2Y12反應單位(PRU)間差異無統計學意義(P>0.05);術後24hA組PRU低于B組(P<0.05)。隨訪6箇月,A組腦血管意外1例;B組心肌梗死1例,心力衰竭1例,腦血管意外4例;兩組主要不良心血管事件(MACE)髮生率比較,差異有統計學意義(χ2=3.752,P<0.05)。兩組總齣血事件髮生率(A組主要齣血1例,小齣血2例,輕微齣血3例;B組主要齣血1例,小齣血3例,輕微齣血4例)間差異無統計學意義(χ2=0.287,P>0.05)。A組重度呼吸睏難1例,中度1例,輕度2例;B組未見呼吸睏難者。兩組術後24h丙氨痠氨基轉移酶(ALT)水平間差異無統計學意義(P>0.05);A組術後24h肌酐(Cr)水平高于B組(P<0.05)。結論替格瑞洛較氯吡格雷具有更好的抗血小闆聚集作用,且不增加齣血風險,肝腎損傷風險低,對擇期行PCI不穩定型心絞痛患者的安全性較好。
목적:탐토불은정형심교통환자경피관상동맥개입치료(PCI)중사용체격서락적료효여안전성。방법선택2013년2월—2014년5월재당산시공인의원택기행PCI적불은정형심교통환자105례,채용수궤수자표법분위A조(n=52)화B조(n=53)。량조술전、술후균급여아사필림,A조재차기출상가복체격서락(술전부하량180mg/차,1차/d;술후표준량90mg/차,2차/d);B조가용록필격뢰(술전부하량300mg/차,1차/d;술후표준량75mg/d,1차/d),료정6개월。결과술전량조혈소판P2Y12반응단위(PRU)간차이무통계학의의(P>0.05);술후24hA조PRU저우B조(P<0.05)。수방6개월,A조뇌혈관의외1례;B조심기경사1례,심력쇠갈1례,뇌혈관의외4례;량조주요불양심혈관사건(MACE)발생솔비교,차이유통계학의의(χ2=3.752,P<0.05)。량조총출혈사건발생솔(A조주요출혈1례,소출혈2례,경미출혈3례;B조주요출혈1례,소출혈3례,경미출혈4례)간차이무통계학의의(χ2=0.287,P>0.05)。A조중도호흡곤난1례,중도1례,경도2례;B조미견호흡곤난자。량조술후24h병안산안기전이매(ALT)수평간차이무통계학의의(P>0.05);A조술후24h기항(Cr)수평고우B조(P<0.05)。결론체격서락교록필격뢰구유경호적항혈소판취집작용,차불증가출혈풍험,간신손상풍험저,대택기행PCI불은정형심교통환자적안전성교호。
Objectjve To evaluate the effect and safety of ticagrelor on patients with unstable angina undergoing selective percutaneous coronary intervention(PCI). Methods The patients with unstable angina who had completed selective PCI between Februray 2013 and May 2014 in Tangshan Worker Hospital were randomly divided into group A(n = 52)who were added ticagrelor(load quantity 180 mg per time before operation,1 time 1 day;standard quantity 90 mg per time,2 times 1 day after operation)and group B(n = 53)who were treated by additional clopidogrel(load quantity 300 mg per time,1 time 1 day before operation;standard quantity 75 mg per time,1 time 1 day after operation),besides administration of aspirin before and after operation,the period of treatment was six months. Results The difference in platelet P2Y12 response units(PRU) between the two groups before operation was not statistically significant(P > 0. 05);PRU of group A was lower than that of group B 24 h after operation and the difference was significant( P < 0. 05). The main adverse cardiac events( MACE)during 6 months′follow - up appeared in both groups:in group A,one case of cerebrovascular accident;in group B,one case of Myocardial Infarction,one case of heart failure and four cases of cerebrovascular accident;the difference of those between the two groups was significant( χ2 = 3. 752,P < 0. 05 ). The incidence of the total bleeding events in both groups was not statistically significant( severe bleeding one case,small bleeding two cases,slight bleeding three cases in group A;severe bleeding one case,small bleeding three cases,slightly bleeding four cases in group B)( χ2 = 0. 287,P > 0. 05). Some patients in group A were found with respiratory difficulty:one severe,one moderate and two mild;no such patients were found in group B. 24 h after operation,the difference of platelet ALT level between the two groups was not significant(P > 0. 05);Cr value of group A was significantly higher than that of group B( P < 0. 05). Conclusjon Ticagrelor has better anti - platelet aggregation effects with no added bleeding risk and low risk of liver and kidney injury. Ticagrelor shows good safety in treating patients with unstable angina undergoing PCI.