在基层医院应用替格瑞洛治疗急性冠脉综合征临床效果及安全性研究

A study of the clinical efficacy and safety of Ticagrelor in the treatment of acute coronary syndrome in the basic level hospital

目的分析在基层医院应用替格瑞洛治疗急性冠脉综合征的临床效果及安全性。方法回顾性分析2015年1月~2017年5月于北京市延庆区医院就诊的急性冠脉综合征患者97例,根据选择的抗双联抗血小板方案分为两组:替格瑞洛组(同时服用替格瑞洛和阿司匹林,n=49)和氯吡格雷组(同时服用氯吡格雷和阿司匹林,n=48)。随访6个月,比较两组主要不良心血管事件、出血风险及药物不良反应发生率。结果替格瑞洛组患者的主要不良心血管件发生率(2.04%)显著低于氯吡格雷组(14.58%),差异有统计学意义(P<0.05),但两组患者出血事件发生率比较差异无统计学意义(P>0.05)。替格瑞洛组药物不良反应发生率为18.4%,氯吡格雷组药物不良反应发生率为6.25%,两组比较差异无统计学意义(P>0.05)。结论应用替格瑞洛联合阿司匹林治疗急性冠脉综合征可显著降低患者的心血管不良事件发生率,不增加出血风险,安全有效,值得基层医院推广。

Objective To analyze the clinical efficacy and safety of Ticagrelor in the treatment of patients with acute cornoary syndrome(ACS)in the basic level hospital.Methods A total of 97 patients with acute coronary syndrome was analyzed retrospectively in Beijing Yanqing Hospital from January 2015 to May 2017.According to dual antiplatelet therapy,they were divided into Ticagrelor group(n=49,treated with Ticagrelor combined with Aspirin)and Clopidogrel group(n=48,treated with Clopidogrel combined with Aspirin).Major adverse cardiac events(MACE),the risk of bleeding and adverse drug reactions(ADR)were compared after a follow-up of 6 months.Results Compared with the Clopidogrel group(14.58%),the incidence of MACE of Ticagrelor group(2.04%)was significant decreased and there was significant difference(P<0.05).But there was no significant difference in the incidence of bleeding event rates between the two groups(P>0.05).Compared with the clopidogrel group(6.25%),the ADR of ticagrelor group(18.4%)was increased,but there was no statistically significant difference(P>0.05).Conclusion Ticagrelor combined with Aspirin can decrease the MACE incidence of ACS and do not increase the risk of bleeding.It is safe,effective and worth popularizing in the basic level hospital.