中国循证心血管医学杂志
中國循證心血管醫學雜誌
중국순증심혈관의학잡지
CHINESE JOURNAL OF EVIDENCE-BASES CARDIOVASCULAR MEDICINE
2015年
4期
533-536
,共4页
侯方杰%邢明青%王晏平%吴娜%延荣强%任永强%马颖%WANG Hai-yang%SHI Yue%WANG Zheng-zhong%YU Zhong-xiang%LIN Xian-ru%GUAN Jun
侯方傑%邢明青%王晏平%吳娜%延榮彊%任永彊%馬穎%WANG Hai-yang%SHI Yue%WANG Zheng-zhong%YU Zhong-xiang%LIN Xian-ru%GUAN Jun
후방걸%형명청%왕안평%오나%연영강%임영강%마영%WANG Hai-yang%SHI Yue%WANG Zheng-zhong%YU Zhong-xiang%LIN Xian-ru%GUAN Jun
替格瑞洛%急诊PCI%急性心肌梗死
替格瑞洛%急診PCI%急性心肌梗死
체격서락%급진PCI%급성심기경사
Ticagrelor%Emergency percutaneous coronary intervention%Acute myocardial infarction
目的：探讨替格瑞洛在急诊经皮冠状动脉介入治疗（PCI）术中应用的疗效及安全性。方法2013年1月至2014年3月在我院诊断为急性心肌梗死并急诊行PCI术的患者共192例，随机分为替格瑞洛组（n=105）和氯吡格雷组（n=87），对两组患者的临床资料进行统计学分析，对比住院期间及随访3月不稳定性心绞痛、心肌梗死、死亡等主要不良心脑血管事件（MACCE）发生率及出血、呼吸困难等不良事件发生率。结果两组的基本情况无统计学差异（P＞0.05）；术后随访3个月发现MACCE事件发生率替格瑞洛组明显低于氯吡格雷组（P＜0.05），出血发生率两组无统计学差异（P＞0.05）；氯吡格雷组中有6例再发急性冠脉综合征（ACS），均再次行PCI干预，改用替格瑞洛术前负荷剂量180 mg，术后90 mg 2/日，分别于术前及后24 h查血栓弹力图，结果显示ADP抑制率及ADP诱导的血小板-纤维蛋白凝块强度（MAADP）应用替格瑞洛后均优于应用替格瑞洛前（P＜0.05）。结论替格瑞洛较氯吡格雷在我国人群急诊PCI术中具有更好的疗效及安全性。
目的：探討替格瑞洛在急診經皮冠狀動脈介入治療（PCI）術中應用的療效及安全性。方法2013年1月至2014年3月在我院診斷為急性心肌梗死併急診行PCI術的患者共192例，隨機分為替格瑞洛組（n=105）和氯吡格雷組（n=87），對兩組患者的臨床資料進行統計學分析，對比住院期間及隨訪3月不穩定性心絞痛、心肌梗死、死亡等主要不良心腦血管事件（MACCE）髮生率及齣血、呼吸睏難等不良事件髮生率。結果兩組的基本情況無統計學差異（P＞0.05）；術後隨訪3箇月髮現MACCE事件髮生率替格瑞洛組明顯低于氯吡格雷組（P＜0.05），齣血髮生率兩組無統計學差異（P＞0.05）；氯吡格雷組中有6例再髮急性冠脈綜閤徵（ACS），均再次行PCI榦預，改用替格瑞洛術前負荷劑量180 mg，術後90 mg 2/日，分彆于術前及後24 h查血栓彈力圖，結果顯示ADP抑製率及ADP誘導的血小闆-纖維蛋白凝塊彊度（MAADP）應用替格瑞洛後均優于應用替格瑞洛前（P＜0.05）。結論替格瑞洛較氯吡格雷在我國人群急診PCI術中具有更好的療效及安全性。
목적：탐토체격서락재급진경피관상동맥개입치료（PCI）술중응용적료효급안전성。방법2013년1월지2014년3월재아원진단위급성심기경사병급진행PCI술적환자공192례，수궤분위체격서락조（n=105）화록필격뢰조（n=87），대량조환자적림상자료진행통계학분석，대비주원기간급수방3월불은정성심교통、심기경사、사망등주요불양심뇌혈관사건（MACCE）발생솔급출혈、호흡곤난등불량사건발생솔。결과량조적기본정황무통계학차이（P＞0.05）；술후수방3개월발현MACCE사건발생솔체격서락조명현저우록필격뢰조（P＜0.05），출혈발생솔량조무통계학차이（P＞0.05）；록필격뢰조중유6례재발급성관맥종합정（ACS），균재차행PCI간예，개용체격서락술전부하제량180 mg，술후90 mg 2/일，분별우술전급후24 h사혈전탄력도，결과현시ADP억제솔급ADP유도적혈소판-섬유단백응괴강도（MAADP）응용체격서락후균우우응용체격서락전（P＜0.05）。결론체격서락교록필격뢰재아국인군급진PCI술중구유경호적료효급안전성。
Objective To discuss the curative effect and safety of ticagrelor administrated in emergency percutaneous coronary intervention (PCI). Methods The patients (n=192) with acute myocardial infarction (AMI) undergone emergency PCI were chosen from Jan. 2013 to Mar. 2014, and randomly divided into ticagrelor group (n=105) and clopidogrel group (n=87). The clinical data of patients were analyzed statistically. The incidence of major adverse cardiovascular and cerebrovascular events (MACCE, including unstable angina pectoris, myocardial infarction and death), bleeding and dyspnea were compared between 2 groups during hospital stay and after follow-up for 3 m. Results The general conditions had no statistical difference between 2 groups (P>0.05). After follow-up for 3 m, the incidence of MACCE was significantly lower in ticagrelor group than that in clopidogrel group (P<0.05), and incidence of bleeding had no statistical difference between 2 groups (P>0.05). There were 6 cases with recurrent acute coronary syndrome (ACS) in clopidogrel group, and then they were given secondary PCI and ticagrelor replacing clopidogrel (preoperative dose of 180 mg and 90 mg three times a day after PCI). These patients were given thrombelastogram examination before and 24 h after PCI, and the outcomes showed that ADP inhibitory rate and ADP-induced platelet-fibrin clot strength (MAADP) were all higher after ticagrelor administration (P<0.05). Conclusion Ticagrelor has higher curative effect and safety than clopidogrel in population undergone emergency PCI.
