替格瑞洛治疗急性冠脉综合征临床价值
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摘要
目的探讨替格瑞洛治疗急性冠脉综合征的临床价值。方法选取自2015年1月至2016年1月收治的120例急性冠脉综合征患者为研究对象,采用随机数字表法分为A组与B组,每组各60例。A组患者给予氯吡格雷+阿司匹林治疗,B组患者给予替格瑞洛+阿司匹林治疗。比较两组患者治疗有效率、血浆黏度、全血黏度、血小板聚集率、主要不良心脑血管事件发生情况以及并发症发生情况。结果 B组患者治疗总有效率为93. 3%(56/60),显著高于A组的81. 7%(49/60),差异有统计学意义(P <0. 05)。治疗后,两组患者血浆黏度、全血黏度及血小板聚集率均较治疗前明显降低,且B组患者上述指标均低于A组,差异均有统计学意义(P <0. 05)。B组患者主要不良心脑血管事件发生率为11. 7%(7/60),显著低于A组的31. 7%(19/60),差异有统计学意义(P <0. 05)。两组患者均未出现重度出血。A组患者出血4例,呼吸困难1例,并发症发生率为8. 3%(5/60); B组患者出血6例,呼吸困难1例,并发症发生率为11. 7%(7/60)。两组患者并发症发生率比较,差异无统计学意义(P> 0. 05)。结论替格瑞洛治疗急性冠脉综合征疗效显著,能有效降低主要不良心脑血管事件发生率,安全性高。
Objective To investigate the clinical value of Ticagrelor in the treatment of acute coronary syndrome( ACS). Methods A retrospective study was performed on 120 cases of patients with ACS who were admitted from January 2015 to January 2016. Patients were randomly divided into the Group A and Group B,with 60 cases in each group. Patients in the Group A were given Clopidogrel combined with asprin,the others in the Group B were given Ticagrelor combined with asprin. The effective rate,plasma viscosity,whole blood viscosity,platelet aggregation rate,adverse cardiovascular events and complications were compared between the two groups. Results The total effective rate of the Group B was 93. 3%( 56/60),which was significantly higher than 81. 7%( 49/60) of the Group A( P < 0. 05). After treatment,plasma viscosity,whole blood viscosity and platelet aggregation rate of the two groups were significantly lower than those before treatment,and the above indexes of the patients in Group B were lower than those in Group A( P < 0. 05). The incidence of adverse cardiovascular events in Group B was 11. 7%( 7/60),significantly lower than 31. 7%( 19/60) in Group A( P <0. 05). No severe bleeding occurred in either group. In Group A,there were 4 cases of bleeding and 1 case of dyspnea,and the complication rate was 8. 3%( 5/60). Six patients in Group B had bleeding and one had dyspnea,and the incidence of complications was11. 7%( 7/60). There was no significant difference in the incidence of complications between the two groups( P > 0. 05).Conclusion Ticagrelor is effective in the treatment of acute coronary syndrome,which can effectively reduce the incidence of adverse cardiovascular events with high safety.
Objective To investigate the clinical value of Ticagrelor in the treatment of acute coronary syndrome( ACS). Methods A retrospective study was performed on 120 cases of patients with ACS who were admitted from January 2015 to January 2016. Patients were randomly divided into the Group A and Group B,with 60 cases in each group. Patients in the Group A were given Clopidogrel combined with asprin,the others in the Group B were given Ticagrelor combined with asprin. The effective rate,plasma viscosity,whole blood viscosity,platelet aggregation rate,adverse cardiovascular events and complications were compared between the two groups. Results The total effective rate of the Group B was 93. 3%( 56/60),which was significantly higher than 81. 7%( 49/60) of the Group A( P < 0. 05). After treatment,plasma viscosity,whole blood viscosity and platelet aggregation rate of the two groups were significantly lower than those before treatment,and the above indexes of the patients in Group B were lower than those in Group A( P < 0. 05). The incidence of adverse cardiovascular events in Group B was 11. 7%( 7/60),significantly lower than 31. 7%( 19/60) in Group A( P <0. 05). No severe bleeding occurred in either group. In Group A,there were 4 cases of bleeding and 1 case of dyspnea,and the complication rate was 8. 3%( 5/60). Six patients in Group B had bleeding and one had dyspnea,and the incidence of complications was11. 7%( 7/60). There was no significant difference in the incidence of complications between the two groups( P > 0. 05).Conclusion Ticagrelor is effective in the treatment of acute coronary syndrome,which can effectively reduce the incidence of adverse cardiovascular events with high safety.
引文
[1]孙毅,张剑,梁延春,等.急性冠脉综合征患者选择不同方式运动康复疗效分析[J].临床军医杂志,2018,46(10):1156-1159.
[2]贾国伟.急性冠脉综合征PCI术后患者应用替格瑞洛及氯吡格雷治疗的临床效果比较[J].中国医药导刊,2016,18(2):181-185.
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[4]刘湘华,梁力晖,唐铭翔.老年非ST段抬高型急性冠脉综合征患者a VR导联ST段抬高与住院主要不良心脏事件的关系[J].川北医学院学报,2016,31(1):51-54.
[5]侯建同,鄢高亮,朱伯谦,等.血清γ谷氨酰转肽酶对急性冠脉综合征患者介入治疗后发生造影剂肾病的影响[J].现代医学,2017,45(1):28-32.
[6]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(6):374-376.
[7]韩雅玲.合并高出血及缺血风险急性冠脉综合征患者抗血小板治疗进展[J].临床军医杂志,2018,46(5):495-506,490.
[8]梁茜,张健瑜,杨希立,等.急性冠脉综合征合并糖尿病患者经皮冠脉介入术后替格瑞洛与氯吡格雷的疗效比较[J].中国医科大学学报,2016,45(2):145-149.
[9]孙蓉媛,王岚峰.急性冠脉综合征的标志物研究进展[J].中血栓与止血学,2012,18(2):87-89.
[10]吴多博,曹鹏,胡方圆,等.氯吡格雷和替格瑞洛在急性冠状动脉综合征介入治疗后应用安全性Meta分析[J].临床军医杂志,2018,46(5):544-547.
[11]潘彩虹,胡泽平,王邦宁.替格瑞洛和氯吡格雷对急性冠脉综合征合并糖尿病患者的血小板抑制作用[J].安徽医科大学学报,2015,50(9):1351-1353.
[12]杨晓伟,张君毅,易甫,等.替格瑞洛对急性冠状动脉综合征择期介入治疗患者近中期疗效观察[J].中华临床医师杂志(电子版),2013,7(19):8696-8700.
[13]李超,李毅,裘淼涵,等.基因型指导下急性冠脉综合征患者择期经皮冠状动脉介入术后应用替格瑞洛与氯吡格雷有效性分析[J].临床军医杂志,2017,45(10):995-999.
[2]贾国伟.急性冠脉综合征PCI术后患者应用替格瑞洛及氯吡格雷治疗的临床效果比较[J].中国医药导刊,2016,18(2):181-185.
[3]高鹏,仲宁,畅君毅.替格瑞洛与氯吡格雷对急性冠脉综合征患者PCI术后血小板功能和炎症因子的影响[J].中国循证心血管医学杂志,2015,7(6):763-769.
[4]刘湘华,梁力晖,唐铭翔.老年非ST段抬高型急性冠脉综合征患者a VR导联ST段抬高与住院主要不良心脏事件的关系[J].川北医学院学报,2016,31(1):51-54.
[5]侯建同,鄢高亮,朱伯谦,等.血清γ谷氨酰转肽酶对急性冠脉综合征患者介入治疗后发生造影剂肾病的影响[J].现代医学,2017,45(1):28-32.
[6]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(6):374-376.
[7]韩雅玲.合并高出血及缺血风险急性冠脉综合征患者抗血小板治疗进展[J].临床军医杂志,2018,46(5):495-506,490.
[8]梁茜,张健瑜,杨希立,等.急性冠脉综合征合并糖尿病患者经皮冠脉介入术后替格瑞洛与氯吡格雷的疗效比较[J].中国医科大学学报,2016,45(2):145-149.
[9]孙蓉媛,王岚峰.急性冠脉综合征的标志物研究进展[J].中血栓与止血学,2012,18(2):87-89.
[10]吴多博,曹鹏,胡方圆,等.氯吡格雷和替格瑞洛在急性冠状动脉综合征介入治疗后应用安全性Meta分析[J].临床军医杂志,2018,46(5):544-547.
[11]潘彩虹,胡泽平,王邦宁.替格瑞洛和氯吡格雷对急性冠脉综合征合并糖尿病患者的血小板抑制作用[J].安徽医科大学学报,2015,50(9):1351-1353.
[12]杨晓伟,张君毅,易甫,等.替格瑞洛对急性冠状动脉综合征择期介入治疗患者近中期疗效观察[J].中华临床医师杂志(电子版),2013,7(19):8696-8700.
[13]李超,李毅,裘淼涵,等.基因型指导下急性冠脉综合征患者择期经皮冠状动脉介入术后应用替格瑞洛与氯吡格雷有效性分析[J].临床军医杂志,2017,45(10):995-999.