替格瑞洛、阿司匹林、替罗非班联合用于经皮冠状动脉介入治疗术后患者的疗效与安全性观察

Clinical Efficacy and Safety of Ticagrelor Combined Aspirin and Tirofiban in Patients Received Percutaneous Coronary Intervention

目的观察替格瑞洛、替罗非班、阿司匹林联合用于PCI术后患者的疗效与安全性。方法选取符合标准的200例患者,将其随机分为替格瑞洛观察组100例,氯吡格雷对照组100例。所有患者入院均给予阿司匹林负荷剂量300mg,随后100mg,1次/天;观察组给予替格瑞洛负荷剂量180mg,随后90mg,2次/天;对照组给予氯吡格雷负荷剂量300mg,随后75mg,1次/天;所有患者术后均给予替罗非班持续泵入36h。研究的主要有效终点为三联抗血小板治疗期间的主要不良心血管事件;主要安全性结果为出血、血小板减少、心动过缓与呼吸困难。结果观察期间对照组发生1例支架内急性血栓事件,观察组无主要不良心血管事件发生,差异无统计学意义(P>0.05);两组均无主要及其他主要出血事件发生,次要出血和轻微出血观察组均多于对照组,差异无统计学意义(P>0.05);呼吸困难观察组多于对照组,血小板减少事件对照组多于观察组,差异无统计学意义(P>0.05)。结论与氯吡格雷相比,替格瑞洛与替罗非班、阿司匹林联合用于PCI术后患者不增加主要及其他主要出血。

Objective To observe the clinical efficacy and safety of ticagrelor combined aspirin and tirofiban in patients received percutaneous coronary intervention. Methods Totally 200 patients who matched to select standard, were randomly divided into ticagrelor observation group and clopidogrel control group, with 100 cases in each group. All enrolled patients received aspirin loading doses 300mg, followed by maintenance doses 100mg once daily. The observation group was given ticagrelor loading doses 180mg, then 90mg twice daily. The control group was administrated clopidogrel loading dosage 300mg, then 75mg, once a day. All patients were treated with tirofiban continuous infusion of 36 hours. The primary efficacy end point are major adverse cardiovascular events during triple antiplatelet therapy. The primary safety variables were bleeding, thrombocytopenia, bradycardia and dyspnea. Results The control group had one acute stent thrombosis events during the observation period. No occur major adverse cardiovascular events of observation group were found, and the difference had no statistically significant（P 〉 0.05）. No major bleeding and other major bleeding were found in both groups. Secondary bleeding and slight bleeding were increased in the observation group compared with control group, and the difference had no statistically significant（P 〉 0.05 ）. The dyspnea in observation group was more than the control group, the thrombocytopenia in control group was more than the observation group, and the difference had no statistically significant（P 〉 0.05）. Conclusion Compared with clopidogrel, ticagrelor combined aspirin and tirofiban for PCI patients do not increase the risk of major bleeding and other major bleeding.