低剂量替格瑞洛用于老年不稳定型心绞痛患者的疗效分析

Efficacy of low-dose Ticagrelor in treatment of patients with unstable angina pectoris

目的探讨低剂量替格瑞洛用于老年(年龄>60岁)不稳定型心绞痛的疗效。方法选择2019年1至12月浙江中医药大学附属衢州中心医院收治的老年不稳定心绞痛患者126例,随机分为标准剂量组和低剂量组各63例,标准剂量组在口服阿司匹林基础上加服标准剂量替格瑞洛片(首次剂量180 mg,随后90 mg/次,2次/d),低剂量组在口服阿司匹林基础上加服低剂量替格瑞洛(首次剂量120 mg,随后60 mg/次,2次/d),6个月后比较两组治疗效果、缺血和出血风险。结果标准剂量组和低剂量组总有效率分别为90.00%、86.67%,差异无统计学意义(P>0.05);标准剂量组二磷酸腺苷诱导的血小板-纤维蛋白凝块强度、血小板反应指数均低于低剂量组(均P<0.05),两组花生四烯酸抑制率、二磷酸腺苷抑制率比较差异均无统计学意义(均P>0.05);两组患者出血事件发生率比较差异无统计学意义(P>0.05)。结论低剂量替格瑞洛治疗老年不稳定型心绞痛患者的疗效和安全性与标准剂量替格瑞洛相当,且前者更经济。

Objective To investigate the efficacy of different doses of Ticagrelor in treatment of patients with unstable angina.Methods A total of 126 patients with unstable angina treated in our hospital from January to December 2019 were enrolled.Patients were randomly divided into two groups with 63 cases in each group.Oral administration of 180 mg Ticagrelor was given as first dose,then 90 mg b.i.d for patients in standard dose group,and 120 mg Ticagrelor was given as first dose,then 60 mg b.i.d for low dose group.In addition,patients in both groups received aspirin.After 6 months of treatment,clinical efficacy,antiplatelet efficiency,ischemic risk,bleeding risk and adverse events were compared between the two groups.Results There was no significant difference in total effective rate between the two groups(P>0.05).There was no significant difference between the two groups in AA inhibition rate and ADP inhibition rate(P>0.05).MAADP and PRI in the standard dose group were significantly lower than those in the low dose group(all P<0.05).No adverse cardiovascular events occurred in both groups,and there was no significant difference in the incidence of bleeding events between the two groups(P>0.05).Conclusion The efficacy and safety of low dose Ticagrelor in the treatment of unstable angina is comparable to that of standard dose,and it is more economical and applicable.