替格瑞洛致呼吸困难38例分析

Ticagrelor Induced Dyspnea: Thirty-eight Cases Report

目的探讨替格瑞洛在急性冠脉综合症（ACS）治疗过程中致呼吸困难不良反应临床特征及相关因素,便于及早发现、识别该不良反应。方法对2013年5月~2014年1月间38例替格瑞洛致呼吸困难病例进行回顾性分析,总结呼吸困难出现时间、临床表现、缓解规律,与血气、胸部平片表现、B型尿钠肽（BNP）、左心室射血分数（LVEF）等关系。结果 38例患者中,呼吸困难大部分发生在替格瑞洛治疗后1周内（92.11%）;呼吸困难与患者体位无关,81.58%患者无论立卧位均觉呼吸困难;呼吸困难无明显昼夜集中性,8：00~20：00为52.63%,20：00~8：00为47.37%;呼吸困难发生前后血气、胸部平片表现、B型尿钠肽（BNP）、左心室射血分数（LVEF）等监测,没有发现明显差异（P〉0.05）。结论替格瑞洛致呼吸困难与用药时间、昼夜差异、患者体位等无明显相关性,对呼吸功能、BNP、LVEF等客观指标监测有利及时发现,以免造成误诊,及时告知患者,以免增加患者顾虑。

Objective To investigate the clinical features and correlation factors for dyspnea caused by ticagrelor in the treating of acute coronary syndrome（ACS）. Methods A retrospective analysis was done on clinical data of 38 cases with dyspnea after treatment with ticagrelor after ACS from 2013.05 to 2014.01.The relationship between dyspnea and Brain natriuretic peptide（BNP） and left ventricular ejection fraction（LVEF） and so on were studied. Results Results of 38 patients, about 92.11% patients got dyspnea one week after treatment with ticagrelor, and about 81.58% patients felt that dyspnea after treatment with ticagrelor had nothing to do with postural changes. In addition, there was no significant difference of BNP and LVEF before or after dyspnea（P〉0.05）. Conclusions These results suggested that there was no significant relationship between dyspnea and treatment duration and postural changes and the change of BNP and LVEF. By analyzing carefully with the former monitoring data, we found the characteristics of dyspnea caused by ticagrelor in the treating of ACS, and put forward several countermeasures accordingly.