替格瑞洛与氯吡格雷治疗急性ST段抬高型心肌梗死安全性和有效性比较研究

Comparative study on safety and efficacy of the treatment of acute ST segment elevation myocardial infarction with intravenous and clopidogrel

目的比较替格瑞洛与氯吡格雷治疗急性ST段抬高型心肌梗死(ASTEMI)的有效性和安全性。方法选取2018年4月至2018年6月间本院及上饶市人民医院收治的60例ASTEMI患者,随机分为对照组和观察组,每组30例,对照组患者每天给予氯吡格雷75 mg,加用阿司匹林100 mg抗血小板聚集治疗;观察组患者给予替格瑞洛90 mg/次,早晚各1片,并每天加用阿司匹林100 mg抗血小板聚集治疗,两组患者均连续治疗6个月,对比两组患者治疗1周、治疗3个月和治疗6个月时的心脏功能指标[左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)]和ST段回落情况;治疗前1周、治疗3个月和治疗6个月血小板最大聚集率(MAR);治疗1个月、3个月和6个月不良心血管事件(MACE)累积发生率及治疗期间不良反应发生情况。结果经过连续治疗后,观察组与对照组患者的心脏功能指标[左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)]、ST段回落情况和血小板最大聚集率(MAR)对比,差异有统计学意义(P<0.05);观察组与对照组患者治疗期间的不良心血管事件(MACE)累积发生率及不良反应发生情况相比差异无统计学意义。结论针对ASTEMI患者的治疗过程中,应用替格瑞洛和氯吡格雷的安全性和有效性相当,但替格瑞洛能够更有效地抑制患者血小板聚集,具有更强的临床推广应用价值。

Objective Comparison of efficacy and safety of the treatment of acute myocardial infarction(ASTEMI) by ST and clopidogrel.Methods Sixty patients with ASTEMI admitted to our hospital and Shangrao People’ s Hospital from April 2018 to June 2018 were randomly divided into control group and observation group, 30 cases in each group. The patients in control group were given clopidogrel 75 mg/d, and aspirin100 mg/d for anti-platelet aggregation treatment. The patients in observation group were given tegrilol 90 mg/time, twice a day. Aspirin 100 mg/d anti-platelet aggregation therapy, two groups of patients were treated for 6 months. The cardiac function indexes [left ventricular ejection fraction(LVEF), left ventricular end-diastolic diameter(LVEDD)], ST-segment regression were compared between the two groups at 1 week, 3 months and6 months of treatment. Monthly maximum platelet aggregation rate(MAR);cumulative incidence of adverse cardiovascular events(MACE) and adverse reactions during 1, 3 and 6 months of treatment. Results After continuous treatment,there were significant differences in cardiac function index [left ventricular ejection fraction(LVEF), left ventricular end-diastolic diameter(LVEDD)], ST segment regression and maximum platelet aggregation rate(MAR) between the observation group and the control group(P<0.05);adverse cardiovascular events(MACE) were involved in the observation group and the control group during treatment. There was no significant difference in the incidence of adverse reactions between the two groups. Conclusion In the treatment of ASTEMI patients, the safety and efficacy of tiglilo and clopidogrel are comparable, but tiglilo can more effectively inhibit platelet aggregation and has a stronger clinical application value.