替格瑞洛联合阿司匹林治疗急性冠状动脉综合征非血运重建患者的疗效及安全性分析

Efficacy and safety of ticagrelor combined with aspirin in the treatment of patients with acute coronary syndrome without revascularization

目的分析替格瑞洛联合阿司匹林治疗急性冠状动脉综合征(ACS)非血运重建患者的疗效及安全性。方法84例急性冠状动脉综合征非血运重建患者,根据随机数字表法分为对照组和观察组,各42例。对照组采用阿司匹林治疗,观察组在对照组基础上联合替格瑞洛治疗。对比两组治疗效果、血清指标[C反应蛋白(CRP)、心肌肌钙蛋白T(cTnT)和D-二聚体(D-D)]、血小板抑制率、随访情况及一般不良反应发生情况。结果观察组治疗总有效率92.86%高于对照组的76.19%,差异具有统计学意义(P<0.05)。治疗后,两组CRP、cTnT和D-D水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗2、24、48 h后,两组血小板抑制率均高于治疗前,且观察组治疗2 h后血小板抑制率(75.27±20.17)%、治疗24 h后血小板抑制率(75.49±19.43)%、治疗48 h后血小板抑制率(78.32±18.61)%高于对照组的(62.14±5.32)、(63.67±8.52)、(64.35±7.42)%,差异有统计学意义(P<0.05)。观察组主要终点事件发生率7.14%低于对照组的23.81%,次要终点事件发生率11.90%低于对照组的30.95%,差异有统计学意义(P<0.05)。观察组一般不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论替格瑞洛联合阿司匹林治疗ACS非血运重建患者的疗效显著,可有效提高血小板抑制率,减少不良事件的发生,安全性较高,值得应用。

Objective To analyze the efficacy and safety of ticagrelor combined with aspirin in the treatment of patients with acute coronary syndrome(ACS)without revascularization.Methods A total of 84 patients with acute coronary syndrome without revascularization were divided into control group and observation group according to the random numerical table,with 42 cases in each group.The control group was treated with aspirin,and the observation group was treated with ticagrelor on the basis of the control group.Both groups were compared in terms of therapeutic effects,serum indexes[C-reactive protein(CRP),cardiac troponin T(cTnT)and D-dimer(D-D)],platelet inhibition rate,follow-up and occurrence of general adverse reactions.Results The total effective rate of treatment 92.86%in the observation group was higher than 76.19%in the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of CRP,cTnT and D-D in the two groups were lower than those of this group before treatment,and the observation group was lower than the control group.All the differences were statistically significant(P<0.05).After 2,24,and 48 h of treatment,the platelet inhibition rates of the two groups were higher than those of this group before treatment;in the observation group,the platelet inhibition rate was(75.27±20.17)%after 2 h of treatment,(75.49±19.43)%after 24 h of treatment,and(78.32±18.61)%after 48 h of treatment,which were higher than(62.14±5.32),(63.67±8.52),(64.35±7.42)%of the control group;all the differences were statistically significant(P<0.05).The incidence of primary endpoint events 7.14%in the observation group was lower than 23.81%in the control group,and the incidence of secondary endpoint events 11.90%was lower than 30.95%in the control group.All the differences were statistically significant(P<0.05).The incidence of general adverse reactions in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Ticagrelor combined with aspirin has a significant effect on non-revascularization of acute coronary syndrome,which can effectively improve the platelet inhibition rate and reduce the occurrence of adverse events.It is safe and worthy of application.