不同剂量替罗非班联合替格瑞洛对NSTEMI患者短期心血管事件及血小板聚集率的影响

Effect of different doses of terofiban combined with ticagrelor on shortterm cardiovascular events and platelet aggregation rate in patients with non-ST-elevation myocardial infarction

目的探讨不同剂量替罗非班联合替格瑞洛对急性非ST段抬高型心肌梗死(NSTEMI)患者短期心血管事件及血小板聚集率的影响。方法收集128例NSTEMI患者,根据不同用药方式分为替格瑞洛组(A组,n=39)、常规剂量替罗非班联合替格瑞洛组(B组,n=46)和小剂量替罗非班联合替格瑞洛组(C组,n=41)。治疗4周后,比较3组患者的血小板聚集率、血纤维蛋白原(Fib)水平以及心血管事件、不良反应发生率。结果治疗4周后,A组复合项终点事件发生率明显高于B组和C组,差异有统计学意义(P<0.05);治疗1、4周后,B组和C组血小板聚集率、血Fib水平均显著低于A组,差异有统计学意义(P<0.05),B组和C组血小板聚集率、血Fib水平比较差异均无统计学意义;B组不良反应发生率明显高于A组和C组,差异有统计学意义(P<0.05)。结论常规剂量和小剂量替罗非班联合替格瑞洛均可减少NSTEMI患者短期心血管事件的发生,增强血小板聚集的抑制作用,且小剂量的替罗非班减少了不良反应的发生。

AIM To investigate the effect of different doses of terofiban combined with ticagrelor on short-term cardiovascular events and platelet aggregation rate in patients with （NSTEMI）. METHODS One hundred and twenty-eight NSTEMI patients in our hospital were included in the study. According to different treatment methods, the patients were divided into ticagrelor group （group A, n = 39）, the con- ventional dose of tirofiban combined with tieagrelor group （group B, n = 46） and small dose of tirofiban combined with Grillo group （ group C, n = 41 ）. After 4 weeks of treatment, the platelet aggregation rate, fibrinogen （Fib） level and cardiovascular events, and incidence of adverse events were compared between the three groups. RESULTS After 4 weeks of treatment, the occurrence rate of composite endpoint in group A was significantly higher than those in group B and group C （P 〈 0.05 ）. The platelet aggregation rate and blood Fib levels in group B and group C were significantly lower than those in group A （P 〈 0. 05 ）. The incidence of adverse reactions in group B was significantly higher than those in group A and group C （P 〈 0. 05）. CONCLUSION Conventional dose and small dose of tirofiban combined with tieagrelor can reduce short-term cardiovascular events in NSTEMI patients and enhance the inhibition of platelet aggregation. Small dose of tirofiban reduces the incidence of adverse reactions.