替格瑞洛、氯吡格雷治疗不稳定型心绞痛疗效与安全性的比较研究

Comparison of Efficacy and Safety of Tiglilo and Clopidogrel in the Treatment of Patients with Unstable Angina Pectoris

目的比较替格瑞洛、氯吡格雷抗栓治疗不稳定型心绞痛(UAP)的疗效与安全性。方法选取2018年1月—2018年12月在我院心血管内科就诊的108例UAP病人,随机分为氯吡格雷组(54例)和替格瑞洛组(54例),所有UAP病人均给予常规治疗,氯吡格雷组则加用氯吡格雷,替格瑞洛组则加用替格瑞洛,两组均连续治疗4周。观察并比较两组心绞痛发作情况、炎症因子和血脂水平、主要不良心脑血管事件(MACCE)及出血事件发生情况。结果治疗后两组心绞痛发作频率、发作持续时间均有所改善,且替格瑞洛组发作频率、发作持续时间均低于氯吡格雷组(P<0.05)。治疗后,两组超敏C反应蛋白(hs-CRP)、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)水平均降低,且替格瑞洛组hs-CRP、TC、TG、LDL-C水平均低于氯吡格雷组(P<0.05)。治疗后,两组高密度脂蛋白胆固醇(HDL-C)水平均升高,且替格瑞洛组HDL-C水平高于氯吡格雷组(P<0.05)。两组复发再住院、急性冠脉综合征、卒中、心律失常及出血事件的发生率比较,差异均无统计学意义(P>0.05),但替格瑞洛组总MACCE发生率(5.56%)显著低于氯吡格雷组(24.10%,P<0.05)。结论在UAP病人的治疗过程中,替格瑞洛疗效更加显著,可抑制炎症反应以及血脂代谢紊乱,有效缓解UAP病人的临床症状,减少不良反应的发生。

Objective To compare the efficacy and safety of tiglilo and clopidogrel for treatment of patients with unstable angina pectoris(UAP).Methods One hundred and eight patients with UAP visited in cardiovascular medicine department of our hospital were randomly divided into clopidogrel group(54 cases)and tiglillo group(54 cases)from January 2018 to December 2018.All patients with UAP were given routine treatment,the patients in clopidogrel group were added with clopidogrel,the patients in tiglillo group were added with tiglillo,both groups were treated for 4 weeks.The incidence of angina pectoris,the levels of inflammatory factors and lipid,the incidence of major adverse cardio-cerebrovascular events(MACCE)and hemorrhagic events were observed and compared between two groups.Results After treatment,the frequency and duration of angina pectoris in both groups were improved,and the frequency and duration of angina pectoris in tigrillo group were lower than those in clopidogrel group(P<0.05).After treatment,the levels of hs-CRP,triglyceride(TG),cholesterol(TC),and low density lipoprotein(LDL-C)in two groups all decreased,and the levels of hs-CRP,TC,TG,and LDL-C in tiglilo group were lower than those in the clopidogrel group(P<0.05).After treatment,the level of HDL-C in both groups increased,and the level of HDL-C in tigrillo group were higher than those in clopidogrel group(P<0.05).The incidence of total MACCE events in tiglilo group(5.56%)was significantly lower than that in clopidogrel group(24.10%,P<0.05).Conclusion In the treatment of patients with UAP,tegrilol is more effective,which can inhibit inflammation and lipid disorders,effectively relieve clinical symptoms and reduce adverse reactions.