替格瑞洛对氯吡格雷抵抗患者血小板聚集率的影响
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摘要
目的探讨替格瑞洛对氯吡格雷抵抗患者血小板聚集率的影响。方法根据计算机随机法,将80例氯吡格雷抵抗的患者分成两组,每组40例。对照组继续给予氯吡格雷治疗;观察组停用氯吡格雷给予替格瑞洛治疗。比较两组患者血小板聚集率、心脏不良事件发生率以及出血性事件发生情况。结果 (1)服药前两组患者血小板聚集率组间差异无统计学意义(P>0.05);服药后,观察组血小板聚集率明显低于对照组,组间差异有统计学意义(P<0.05)。(2)服药后,观察组心脏不良事件发生率5%(2/40)明显高于对照组15%(6/40),组间差异有统计学意义(P<0.05)。(3)观察组随访期间出血事件发生率5%(2/40)明显低于对照组15%(6/40),组间差异有统计学意义(P<0.05)。结论替格瑞洛能够降低氯吡格雷抵抗患者血小板聚集率,降低心脏不良事件发生率。
Objective To investigate the effect of tigrilol on platelet aggregation rate in the patients with clopidogrel resistance. Methods 80 patients with clopidogrel resistance were randomly divided into observation group and control group. Each group contained 40 patients. The patients in the control group were treated with clopidogrel,and the Patients in the observation group were treated with tigrilol instead of clopidogrel. We compared the platelet aggregation rate,the incidence of adverse cardiac events and the incidence of hemorrhagic events for the patients in the two groups.Results( 1) There was no significant difference in the platelet aggregation rate of the patients between the two groups before taking medicine( P > 0. 05),but the platelet aggregation rate of the patients in the observation group was significantly lower than that in the control group( P < 0. 05).( 2) After taking medicine,the incidence of adverse cardiac events of the patients in the observation group[5%( 2/40) ]was significantly higher than that in the control group [15%( 6/40) ],and the difference between the two groups was significant( P < 0. 05).( 3) The incidence of haemorrhage events of the patients in the observation group [5%( 2/40) ]was significantly lower than that in the control group [15%( 6/40) ],and the difference between the two groups was significant( P < 0. 05). Conclusion Tigrilol can reduce platelet aggregation rate and the incidence of adverse cardiac events of the patients with clopidogrel resistance.
Objective To investigate the effect of tigrilol on platelet aggregation rate in the patients with clopidogrel resistance. Methods 80 patients with clopidogrel resistance were randomly divided into observation group and control group. Each group contained 40 patients. The patients in the control group were treated with clopidogrel,and the Patients in the observation group were treated with tigrilol instead of clopidogrel. We compared the platelet aggregation rate,the incidence of adverse cardiac events and the incidence of hemorrhagic events for the patients in the two groups.Results( 1) There was no significant difference in the platelet aggregation rate of the patients between the two groups before taking medicine( P > 0. 05),but the platelet aggregation rate of the patients in the observation group was significantly lower than that in the control group( P < 0. 05).( 2) After taking medicine,the incidence of adverse cardiac events of the patients in the observation group[5%( 2/40) ]was significantly higher than that in the control group [15%( 6/40) ],and the difference between the two groups was significant( P < 0. 05).( 3) The incidence of haemorrhage events of the patients in the observation group [5%( 2/40) ]was significantly lower than that in the control group [15%( 6/40) ],and the difference between the two groups was significant( P < 0. 05). Conclusion Tigrilol can reduce platelet aggregation rate and the incidence of adverse cardiac events of the patients with clopidogrel resistance.
引文
[1]林毅.2型糖尿病合并急性冠脉综合征患者血尿酸及血脂水平分析[J].天津医药,2013,41(10):1029-1030.
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[3]李延丽.急诊PCI治疗急性ST段抬高型心肌梗死患者539例临床分析[D].银川:宁夏医科大学,2013.
[4]张业明,刘俭雄,关月娥,等.替格瑞洛对PCI术后氯吡格雷抵抗患者血小板聚集率的影响[J].中国实用医药,2016,11(4):129-131.
[5]宋大庆,吴庆建.替格瑞洛在急性ST段抬高型心肌梗死直接经皮冠动脉介入术治疗中的效果[J].中国医药导报,2015,12(4):115-119.
[6]楼善杰,黄诚意,朱劲草,等.替格瑞洛治疗急性冠状动脉综合征疗效观察[J].中华实用诊断与治疗杂志,2015,29(1):90-92.
[7]高珊,刘克坚,邱强.冠心病诊断技术研究进展[J].中华实用诊断与治疗杂志,2010,24(4):318-320.
[8]BONELLO L,TANTRY U S,MARCUCCI R,et al.Consensus and future direction on the definition of high ontreatment platelet reactivi to adenosine diphosphate[J].J Am Coll Cardiol,2010,56(12):919-933..
[9]许骥,华琦,胡少东,等.替格瑞洛在老年STEMI患者急诊PCI中的疗效与安全性分析[J].首都医科大学学报,2015,36(1):73-77.
[10]盘庆飞,黄贤,何秀丽,等.冠心病PCI术后肌钙蛋白I的变化及其临床意义[J].中国实用医药,2016,11(4):24-26.
[11]刘峰,张瑞芳,李梓,等.硫酸氢氯吡格雷联合瑞舒伐他汀钙治疗中老年高脂血症患者的临床疗效[J].中国临床保健杂志,2016,19(3):302-303.
[12]林莉.氯吡格雷对急性脑梗死患者血小板膜糖蛋白、血小板聚集率的影响[J].中国临床保健杂志,2009,12(6):639-641.
[13]PRICE M J.Bedside evaluation of thienopyridine antiplatelet therapy[J].Circulation,2009,119(19):2625-2632.
[14]朱永宏,贾国良,周妙,等.替格瑞洛治疗41例急性冠状动脉综合征患者的临床疗效[J].中国介入心脏病学杂志,2013,21(96):374-376.
[15]杨敏,姜祖超,王文尧,等.替格瑞洛和氯吡格雷对急性ST段抬高心肌梗死直接经皮冠状动脉介入治疗术后慢血流的影响[J].中国介入心脏病学杂志,2015,23(12):667-669.
[16]朱辉,李济民,徐可,等.替格瑞洛对氯吡格雷低反应患者血小板聚集率的影响[J].江苏医药,2016,42(5):516-518.
[17]刘铭,唐海沁,张亚文,等.替格瑞洛治疗急性冠脉综合征患者的Meta分析[J].中国临床保健杂志,2015,18(3):274-278.
[18]孙婧,田军,刘军翔,等.国产比伐卢定用于急性ST段抬高型心肌梗死患者急诊介入治疗术中的临床研究[J].2014,29(7):497-500.
[19]梁鹏,董守仁,崔红营.等.替格瑞洛在老年STEMI患者急诊PCI中的疗效与安全性分析[J].中国临床研究,2014,27(8):937-939.
[20]赵梦华,宋文奇,陈海鱼.替格瑞洛治疗急性冠脉综合征的研究现状[J].临床荟萃,2013,28(11):1308-1311.
[2]WANG Y C,LO P H.Reduced door-to-balloon times in acute ST-elevation my-ocardial infarction patients undergoing primary percutaneous coronary intervention[J].Int J Clin Pract,2012,66(1):69-76.
[3]李延丽.急诊PCI治疗急性ST段抬高型心肌梗死患者539例临床分析[D].银川:宁夏医科大学,2013.
[4]张业明,刘俭雄,关月娥,等.替格瑞洛对PCI术后氯吡格雷抵抗患者血小板聚集率的影响[J].中国实用医药,2016,11(4):129-131.
[5]宋大庆,吴庆建.替格瑞洛在急性ST段抬高型心肌梗死直接经皮冠动脉介入术治疗中的效果[J].中国医药导报,2015,12(4):115-119.
[6]楼善杰,黄诚意,朱劲草,等.替格瑞洛治疗急性冠状动脉综合征疗效观察[J].中华实用诊断与治疗杂志,2015,29(1):90-92.
[7]高珊,刘克坚,邱强.冠心病诊断技术研究进展[J].中华实用诊断与治疗杂志,2010,24(4):318-320.
[8]BONELLO L,TANTRY U S,MARCUCCI R,et al.Consensus and future direction on the definition of high ontreatment platelet reactivi to adenosine diphosphate[J].J Am Coll Cardiol,2010,56(12):919-933..
[9]许骥,华琦,胡少东,等.替格瑞洛在老年STEMI患者急诊PCI中的疗效与安全性分析[J].首都医科大学学报,2015,36(1):73-77.
[10]盘庆飞,黄贤,何秀丽,等.冠心病PCI术后肌钙蛋白I的变化及其临床意义[J].中国实用医药,2016,11(4):24-26.
[11]刘峰,张瑞芳,李梓,等.硫酸氢氯吡格雷联合瑞舒伐他汀钙治疗中老年高脂血症患者的临床疗效[J].中国临床保健杂志,2016,19(3):302-303.
[12]林莉.氯吡格雷对急性脑梗死患者血小板膜糖蛋白、血小板聚集率的影响[J].中国临床保健杂志,2009,12(6):639-641.
[13]PRICE M J.Bedside evaluation of thienopyridine antiplatelet therapy[J].Circulation,2009,119(19):2625-2632.
[14]朱永宏,贾国良,周妙,等.替格瑞洛治疗41例急性冠状动脉综合征患者的临床疗效[J].中国介入心脏病学杂志,2013,21(96):374-376.
[15]杨敏,姜祖超,王文尧,等.替格瑞洛和氯吡格雷对急性ST段抬高心肌梗死直接经皮冠状动脉介入治疗术后慢血流的影响[J].中国介入心脏病学杂志,2015,23(12):667-669.
[16]朱辉,李济民,徐可,等.替格瑞洛对氯吡格雷低反应患者血小板聚集率的影响[J].江苏医药,2016,42(5):516-518.
[17]刘铭,唐海沁,张亚文,等.替格瑞洛治疗急性冠脉综合征患者的Meta分析[J].中国临床保健杂志,2015,18(3):274-278.
[18]孙婧,田军,刘军翔,等.国产比伐卢定用于急性ST段抬高型心肌梗死患者急诊介入治疗术中的临床研究[J].2014,29(7):497-500.
[19]梁鹏,董守仁,崔红营.等.替格瑞洛在老年STEMI患者急诊PCI中的疗效与安全性分析[J].中国临床研究,2014,27(8):937-939.
[20]赵梦华,宋文奇,陈海鱼.替格瑞洛治疗急性冠脉综合征的研究现状[J].临床荟萃,2013,28(11):1308-1311.