替格瑞洛对非ST段抬高型急性冠脉综合征患者疗效及预后的影响

Effect of ticagrelor on clinical efficacy and prognosis in patients with non-ST-segment elevation acute coronary syndrome

目的观察替格瑞洛对非ST段抬高型急性冠状动脉(冠脉)综合征(non-ST-segment elevation acute coronarysyndrome,NSTEACS)患者疗效及预后的影响。方法以380例NSTEACS患者为研究对象,按随机数字表法随机分为对照组(氯吡格雷)和试验组(替格瑞洛),每组190例。检测两组用药前、后血清C-反应蛋白(C-reac-tive protein,CRP)、肌钙蛋白T(troponin T,Tn T)、肌酸激酶同工酶(creatine kinase MB,CKMB)浓度及血小板聚集率,评价两组临床疗效。随访30 d,记录主要心血管事件发生率(major adverse cardiovascular events,MACE);观察用药后出血并发症发生情况。结果两组基线资料比较,差异无统计学意义(P>0.05)。治疗后,试验组血清CRP、Tn T及CKMB浓度比对照组明显降低,差异有统计学意义(P<0.05);同时,用药后试验组血小板聚集率也明显低于对照组,差异有统计学意义(0.28±0.09 vs.0.40±0.11,P<0.05)。试验组治疗的总有效率为93.7%,明显高于对照组的86.8%,差异有统计学意义(P<0.05)。随访30 d,两组MACE发生率比较,差异无统计学意义(P>0.05);对照组与试验组出血事件发生率分别为5.8%和6.3%,两组比较,差异无统计学意义(P>0.05)。结论替格瑞洛能有效地降低心肌损伤标志物,提高临床疗效而不增加出血风险,值得临床运用推广。

Objectives To investigate the effect of ticagrelor on clinical efficacy and prognosis in patients with non-ST-segment elevation acute coronary syndrome（NSTEACS）.Methods The 380 patients with NSTEACS wererandomly divided into control group（clopidogrel）and experimental group（ticagrelor）,190 patients in each group.Serum concentrations of C-reactive protein（CRP）,troponin T（Tn T）,creatine kinase MB（CKMB）and platelet ag-gregation rate level were measured before and after treatment.Clinnical efficacy was evaluated between the two groups.During the thirty-day follow-up,incidence of major adverse cardiovascular events（MACE） and bleeding com-plication was observed.Results Baseline data showed no significant difference between the two groups（P〉0.05）.Compared with control group,serum concentrations of CRP,Tn T and CKMB were significantly lower in experimentalgroup（P〈0.05）.Meanwhile,platelet aggregation rate after treatment in experimental group was significantly lower thanthat in control group（0.28±0.09 vs.0.40±0.11,P〈0.05）.Total effective rate in experimental group was significantlyhigher than that in control group（93.7% vs.86.8%,P〈0.05）.During the thirty-day follow-up,incidence of MACEhad no significant difference between the two groups（P〉0.05）.Incidences of bleeding complications were respectively5.8% and 6.3% in control group and experimental group during the thirty-day follow-up,and had no significantdifference between the two groups（P〈0.05）.Conclusions Ticagrelor can effectively reduce the markers of myocardial injury,improve the clinical efficacy without increasing the risk of bleeding,which is worthy of clinical application andpromotion.