探讨替格瑞洛序贯氯吡格雷治疗老年急性冠脉综合征合并2型糖尿病的临床疗效及安全性

Exploring the Clinical Efficacy and Safety of Ticagrelor Sequential Clopidogrel in the Treatment of Elderly Acute Coronary Syndromes with Type 2 Diabetes

目的探讨替格瑞洛序贯氯吡格雷治疗老年急性冠脉综合征合并2型糖尿病的临床疗效及安全性。方法选取2018年1月—2019年1月该院收治的80例老年急性冠脉综合征合并2型糖尿病患者作为研究对象。所有患者均接受经皮冠状动脉介入(PCI)治疗,采用随机数字表法将其分为观察组与对照组,对照组40例PCI术后采用口服阿司匹林肠溶片及替格瑞洛治疗,观察组40例PCI术后首先口服阿司匹林肠溶片与替格瑞洛,6个月后采用阿司匹林肠溶片与硫酸氢氯吡格雷的治疗方案。比较两组患者风险事件发生情况。结果两组患者术后随访主要与次要心血管重点事件发生率比较差异无统计学意义(P>0.05);两组术后3个月、6个月、12个月时患者血糖相关指标比较差异无统计学意义(P>0.05);但观察组PCI术后出血不良反应发生率明显低于对照组,差异有统计学意义(P<0.05)。结论老年急性冠脉综合征合并2型糖尿病患者PCI术后采用替格瑞洛序贯氯吡格雷治疗方案可有效降低患者出血反应等并发症的发生风险,对改善患者预后结局及生活质量均具有积极作用。

Objective To investigate the clinical efficacy and safety of ticagrelor sequential clopidogrel in the treatment of elderly acute coronary syndromes with type 2 diabetes.Methods From January 2018 to January 2019,80 elderly patients with acute coronary syndrome combined with type 2 diabetes were selected as the research objects.All patients received percutaneous coronary intervention(PCI)and were divided into observation group and control group by random number table method.The control group received oral aspirin enteric-coated tablets and ticagrelor after PCI.Observation In the group of 40 patients after PCI,aspirin enteric-coated tablets and ticagrelor were taken orally first,and aspirin enteric-coated tablets and clopidogrel bisulfate were used 6 months later.The occurrence of risk events between the two groups of patients was compared.Results There was no statistically significant difference in the incidence of major and minor cardiovascular events between the two groups of patients in the postoperative follow-up(P>0.05);the comparison of blood glucose-related indicators in the two groups at 3,6 and 12 months after surgery were all not statistically significant different(P>0.05);but the incidence of bleeding after PCI in the observation group was significantly lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion Sequential clopidogrel treatment with ticagrelor after PCI in elderly patients with acute coronary syndrome and type 2 diabetes can effectively reduce the risk of complications such as bleeding,and improve the prognosis,outcome and quality of life of the patients,which has a positive effect.