替格瑞洛用于急性心肌梗死的临床疗效及安全性研究

Clinical Effect and Safety of Ticagrelor in Treating Acute Myocardial Infarction

目的探讨替格瑞洛治疗急性心肌梗死患者的临床疗效及安全性。方法选择2010年2月至2014年5月医院收治的84例急性心肌梗死患者,随机分为研究组和对照组,各42例。两组患者均实施常规对症支持疗法,对照组加用氯吡格雷及阿司匹林,研究组加用替格瑞洛及阿司匹林。记录两组患者主要心血管事件(MACE)发生率、左心室射血分数(LVEF)、左心室舒张末期半径(LVEDd)、心电图ST段回落情况、血小板计数,并比较用药安全性。结果与对照组比较,研究组第6个月末的MACE累积发生率明显较低(P<0.05),第1个月末的ST段抬高回落良好率较高(P<0.05),第1,6个月末的LVEF均较高(P<0.05),LVEDd均较低(P<0.05)。研究组治疗后第1周及第1,3,6个月末的血小板计数均高于对照组(P<0.05)。研究组主要出血事件发生率低于对照组(P<0.05),两组次要及轻微出血事件发生率差异无统计学意义(P>0.05)。结论替格瑞洛联合阿司匹林用于急性心肌梗死患者,能有效降低心血管事件发生率,并促进冠脉介入术的顺利开展,安全性好,可取得较可观的临床效益。

Objective To explore the clinical effect and safety of ticagrelor in treating myocardial infarction. Methods 84 patients with myocardial infarction admitled to our hospital from February 2010 to May 2014 were selected and randomly divided into the study group and the control group,42 cases in each group. The two groups were performed the conventional symptomatic and supportive therapy. The control group was added with clopidogrel and aspirin,while the study group was added with ticagrelor combined with aspirin. The occurrence rate of the major adverse cardiovascular event（MACE）,left ventricular ejection fraction（LVEF）,left ventricular end diastolic radius（LVEDd）,ST segment resolution and platelet counts were recorded. The medication safety was compared between the two groups. Results Compared with the control group,the cumulative occurrence rate of MACE at the end of 6 months in the study group was obviously lower（P〈0. 05）,the good rates of ST segment resolution in EKG at the end of 1,6 months were higher（P〈0. 05）,LVEF at the end of 1,6 months was higher（P〈0. 05）,LVEDd was lower（P〈0. 05）. The PLT counts at 1 week,and at the end of 1,3,6 months after treatment in the study group were higher than those in the control group（P〈0. 05）. The occurrence rate of major bleeding events in the study group was lower than that in the control group（P〈0. 05）,but the occurrence rate of minor and slight bleeding events had no statistical difference between the two groups（P〉 0. 05）. Conclusion Ticagrelor combined with aspirin for treating the patients with acute myocardial infarction can effectively reduce the incidence of cardiovascular events,promotes the smooth performing of percutaneous coronary intervention,has good safety and can obtain a considerable clinical benefit.