替格瑞洛片联合阿司匹林片治疗老年急性ST段抬高型心肌梗死的临床研究

Clinical trial of ticagrelor tablets combined with aspirin tablets in the treatment of elderly patients with acute ST segment elevation myocardial infarction

目的观察替格瑞洛片联合阿司匹林片治疗老年急性ST段抬高型心肌梗死的临床疗效及安全性。方法将170例老年急性ST段抬高型心肌梗死患者随机分为对照组85例和试验组85例。经皮冠状动脉介入治疗(PCI)术前,对照组予以氯吡格雷每次300 mg,qd,口服+阿司匹林每次300 mg,qd,口服;试验组予以替格瑞洛每次180 mg,qd,口服+阿司匹林每次300 mg,qd,口服。2组患者术前均治疗7 d。PCI术后,对照组予以氯吡格雷每次75 mg,qd,口服+阿司匹林每次100 mg,qd,口服;试验组予以替格瑞洛每次90 mg,qd,口服+阿司匹林每次100 mg,qd,口服。2组患者术后均治疗1年。比较2组患者的临床疗效和药物不良反应的发生情况。结果治疗后,试验组和对照组的总有效率分别为94.12%(80例/85例)和81.18%(69例/85例),差异有统计学意义(P<0.05)。试验组出现皮肤瘀点、恶心和呕吐等药物不良反应,对照组出现便秘、紫癜、腹泻和恶心等药物不良反应。试验组和对照组的总药物不良反应发生率分别为4.71%和5.88%,差异无统计学意义(P>0.05)。结论替格瑞洛片联合阿司匹林片治疗老年急性ST段抬高型心肌梗死的临床疗效确切,且不增加药物不良反应的发生率。

Objective To observe the clinical efficacy and safety of ticagrelor tablets combined with aspirin tablets in the treatment of elderly patients with acute ST segment elevation myocardial infarction. Methods A total of 170 elderly patients with acute ST segment elevation myocardial infarction were randomly divided into control and treatment groups with 85 cases per group. Before percutaneous coronary intervention（ PCI）,control group was given clopidogrel 300 mg per time,qd,orally＋ aspirin 300 mg per time,qd,orally. Treatment group was given ticagrelor 180 mg per time,qd,orally ＋ aspirin 300 mg per time,qd,orally. Two groups were treated for 7 days before operation. After PCI operation,control group was given clopidogrel 75 mg per time,qd,orally＋ aspirin 100 mg per time,qd,orally. Treatment group was given ticagrelor 90 mg per time,qd,orally ＋ aspirin 100 mg per time,qd,orally. Two groups were treated for 1 year after operation. The clinical efficacy and adverse drug reactions of two groups were compared. Results After treatment,the total effective rates of treatment and control groupswere 94. 12%（ 80 cases/85 cases） and 81. 18%（ 69 cases/85 cases） with significant difference（ P〈0. 05）. The adverse drug reactions of treatment group were skin stasis,nausea and vomiting,which in control group were constipation,purpura,diarrhea and nausea. The total incidences of adverse drug reactions in treatment and control groups were4. 71% and 5. 88% without significant difference（ P〉0. 05）. Conclusion Ticagrelor tablets combined with aspirin tablets have a definitive clinical efficacy in the treatment of elderly patients with acute ST segment elevation myocardial infarction,without increasing the incidence of adverse drug reactions.