替格瑞洛在氯吡格雷抵抗的老年女性急性冠脉综合征中的应用

Ticagrelor application in acute coronary syndrome in the elderly women with clopidogrel resistance

目的:探讨替格瑞洛缓解老年女性急性冠脉综合征患者氯吡格雷抵抗的临床效果。方法:以2015年1月至10月在我院治疗并行择期冠脉介入(PCI)手术的老年女性急性冠脉综合征患者为研究对象,筛选出100例存在氯吡格雷抵抗者,将其随机分为对照组(予氯吡格雷治疗)和观察组(予替格瑞洛治疗)。观察比较两组患者术后血小板反应指数(PRI)、PRI达标率以及不良事件发生率的差异。结果:两组用药7、14和30 d后,PRI均下降,且观察组比对照组明显(P<0.05);治疗后,观察组PRI达标率为72%,明显高于对照组(44%)。两组消化道事件和呼吸困难等发生率无明显差异,观察组出血发生率明显低于对照组(P<0.05)。结论:替格瑞洛对老年女性急性冠脉综合征患者氯吡格雷抵抗有较好的缓解作用,且不良事件发生率较低。

Objective： To investigate the effect of ticagrelor to relieve the syndrome of clopidogrel resistance in patients with acute coronary syndrome in elderly women. Methods： Elderly women with acute coronary syndrome treated in our hospital from January 2015 to October 2015 were enrolled as the subjects. One hundred patients with clopidogrel resistance were selected and randomly divided into control group（ clopidogrel therapy） and observation group（ ticagrelor therapy）. The differences of platelet reactivity index（ PRI）,PRI compliance rate and adverse event rates were observed and compared between the two groups. Results： Seven,14,30 days after the treatment,the PRI of the two groups decreased,and the observation group was lower than the control group（ P〈0. 05）. After treatment,the PRI compliance rate of the observation group was 72%,it was significantly higher than that of the control group（ 44%）. There was no significant difference in the incidence of gastrointestinal and respiratory difficulties between the two groups. The incidence of bleeding rate in the observation group was significantly lower than that in the control group（ P〈0. 05）. Conclusions： Ticagrelor has a better effect on clopidogrel resistance in elderly female patients with acute coronary syndrome,and the incidence of adverse events is low.