替格瑞洛在急性冠脉综合征患者应用的有效性与安全性

Efficacy and safety of ticagrelor in patients with acute coronary artery disease

目的探讨替格瑞洛在急性冠脉综合征(ACS)患者应用的有效性与安全性。方法ACS患者180例随机均分为试验组(口服负荷量替格瑞洛180mg,维持量90mg,每天2次)与对照组(口服负荷量氯吡格雷300mg,维持量75mg,每天1次),随访治疗6个月时主要心血管事件及出血等不良反应的发生情况。结果随访6个月,试验组发生心源性或脑源性死亡、再发心肌梗死或心绞痛发生率低于对照组(P<0.05),但微小出血、呼吸困难、新发缓慢型心律失常发生率和血尿酸增高的比例均高于对照组(P<0.05)。两组间支架内血栓或支架内再狭窄、卒中或短暂性脑缺血及其他动脉栓塞和心律失常发生率、血肌酐及ALT增高比值差异无统计学意义(P>0.05)。结论与氯吡格雷比较,替格瑞洛治疗ACS具有更好的疗效,不良反应可以接受。

Objective To investigate the efficacy and safety of acute coronary syndrome （ACS）. Methods A total of 180 patients ticagrelor in the patients with with ACS was randomly and equally divided into two groups. The patients in group A were treated with oral ticagrelor in a loading dose 180 mg,which was followed by a maintenance dose of ticagrelor 90 mg,twice a day. The patients in group B were treated with oral clopidogrel in a loading dose 300 mg, which was followed by a maintenance dose of clopidogrel 75 mg,once a day. The adverse effects including cardiovascular events and bleeding were followed-up for 6 months. Results The incidence rates of cardiogenic or brain- derived mortality,re-myocardial infarction and angina pectoris attack were lower, but the percentages of minor bleeding, breathing difficulties, new type of slow arrhythmia and increased blood uric acid were higher, in group A than those in group B（P〈0.05）. There were no significant differences in the incidence rates of stent thrombosis or restenosis, stroke or transient isehemia, other artery embolization and arrhythmia, increases of serum creatinine and ALT between two groups（P〉0. 05）. Conclusion Compared with clopidogrel, ticagrelor has better efficacy with acceptable adverse effects in the treatment of patients with ACS.