替格瑞洛对急性冠脉综合征疗效与安全性的研究

Efficacy and safety evaluation of Ticagrelor in acute coronary syndrome

目的观察替格瑞洛治疗急性冠脉综合征（ACS）的疗效与安全性。方法选取我院2015年1月至2017年1月确诊ACS患者120例，包含急性心梗（STEMI和NSTEMI）、不稳定型心绞痛（UA），均行支架植入（PCI）或球囊扩张（阿cA）治疗，依据用药不同分为替格瑞洛组（60例）和硫酸氢氯吡格雷对照组（60例），对比观察两组在术中及术后6个月的主要心脑血管事件（MACCE）及严重出血等不良反应发生情况。结果两组治疗后与本组治疗前比较冠脉血流都有明显改善（P〈0．05），但替格瑞洛观察组TIMI血流改善更明显。无论是术中还是术后6个月，替格瑞洛组主要心血管不良事件包括心绞痛再发、心肌梗死再发及支架内血栓均低于硫酸氢氯吡格雷组（P〈0．05）；而严重出血、呼吸困难、心动过缓不良反应无明显增加，二者无统计学差异（P〉0．05）。结论对于ACS患者，替格瑞洛联合阿司匹林抗栓治疗，明显降低严重心血管事件风险，而严重出血等不良事件无明显增加。

Objective To observe the efficacy and safety of Ticagrelor in the treatment of acute coronary syndromes. Methods 120 cases of ACS patients diagnosed in our hospital fi＇om January 2015 to January 2017 were selected, including acute myocardial infarction and unstable angina pectoris. Stent implantation or balloon di- latation were performed and divided into two groups according to the medication： 60 patients in the control group （Clopidogrel） and 60 patients with Ticagrelor. The adverse effects of MACCE and severe bleeding and dyspnea were observed in the two groups during the operation and 6 months after the operation. Results Comparing with pre treated group, the TIMI of either the control group or the Ticagrelor group was significant improved （P〈0.05）. The improvement of Ticagrelor group was better than the control group. Both the 6 months of intraoperative or post- operative, Ticagrelor group major adverse cardiovascular and cerebrovascular events including angina pectoris, my- ocardial infarction and stent thrombosis were significantly lower than that of Clopidogrel group （P〈0.05）. And se- vere bleeding, dyspnea, bradycardia, adverse reactions did not increase significantly, and there was no signif- icant difference between the two （P〉0.05）. Conclusion For ACS patients, the combination of Ticagrelor and Aspirin therapy significantly reduces the risk of severe cardiovascular events, while severe bleeding and other ad- verse events have not increased significantly.