摘要
目的探讨替格瑞洛抗血小板治疗冠状动脉严重钙化的急性冠状动脉综合征(acute coronary syndrome, ACS)的临床疗效和安全性。方法冠状动脉严重钙化行经皮冠状动脉介入手术的ACS患者98例,随机分为观察组和对照组各49例。在常规治疗基础上,观察组给予替格瑞洛180 mg负荷量后,按90 mg/次,2次/d口服;对照组给予氯吡格雷300 mg负荷量后,按75 mg/次,1次/d治疗;2组均同时应用阿司匹林100 mg,1次/d口服;治疗12个月,比较2组主要心血管不良事件发生率、血清C反应蛋白、氨基末端脑钠肽前体水平以及出血发生情况。结果治疗12个月后,观察组和对照组血清C反应蛋白[(1.98±0.38)、(2.92±0.45)mg/L]、氨基末端脑钠肽前体水平[(62.18±4.57)、(73.45±3.26)ng/L]均较治疗前[(3.19±0.86)、(3.26±0.92)mg/L,(152.32±2.39)、(151.12±2.86)ng/L]降低(P<0.05),且观察组低于对照组(P<0.05);观察组主要心血管不良事件发生率(6.12%)低于对照组(26.53%)(P<0.05),非严重出血事件发生率(14.29%)与对照组(20.41%)比较差异无统计学意义(P>0.05)。结论替格瑞洛抗血小板治疗冠状动脉严重钙化的ACS疗效确切,安全性好。
Objective To investigate the clinical effect and safety of ticagrelor antiplatelet therapy for acute coronary syndrome(ACS) caused by severe coronary calcification. Methods Ninety-eight patients with ACS caused by severe coronary calcification undergoing percutaneous coronary intervention were divided into observation group and control group, with 49 patients in each group. On the basis of conventional treatment, observation group was given oral administration of ticagrelor 180 mg of load, followed by 90 mg per time, twice a day, and control group was given oral administration of 300 mg of clopidogrel, followed by 75 mg per time, once a day. Meanwhile, both groups were orally administrated with aspirin 100 mg, once a day. After 12-month treatment, the incidence of major cardiovascular adverse events, serum C-reactive protein level, amino-terminal pro-brain natriuretic peptide level, and hemorrhage incidence were compared between two groups. Results The levels of serum C-reactive protein((1.98±0.38),(2.92±0.45) mg/L) and amino-terminal pro-brain natriuretic peptide((62.18±4.57),(73.45±3.26) ng/L) after 12-month treatment were significantly lower than those before treatment((3.19±0.86),(3.26±0.92) mg/L;(152.32±2.39),(151.12±2.86) ng/L) in observation group and control group(P<0.05), and lower in observation group than those in control group(P<0.05). The incidence of major cardiovascular adverse events was significantly lower in observation group(6.12 %) than that in control group(26.53%)(P<0.05), and there was no significant difference in the incidence of severe hemorrhage between two groups(14.29% vs. 20.41%)(P>0.05). Conclusion The antiplatelet therapy by ticagrelor is effective and safe for ACS caused by severe coronary artery calcification.
引文
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