替格瑞洛与氯吡格雷对急性冠脉综合征非血运重建患者疗效及不良事件的影响比较

Comparison of Ticagrelor and Clopidogrel on Efficacy and Adverse Events in Patients with Acute Coronary Syndrome Undergoing Non-revascularization

目的:比较替格瑞洛与氯吡格雷对急性冠脉综合征(ACS)非血运重建患者疗效及不良事件的影响。方法:选择2018年1月-2021年1月沈阳二四五医院收治的ACS非血运重建患者180例为研究对象。根据治疗方法的不同将患者分为观察组(n=80)与对照组(n=100)。两组均给予阿司匹林治疗,在此基础上,观察组给予替格瑞洛治疗,对照组给予氯吡格雷治疗。记录比较两组治疗前及治疗1、6个月后左室射血分数(LVEF)、左心室舒张末期直径(LVEDD)、血小板计数(PLT)、心肌肌钙蛋白(cTnI)、B型脑钠肽(BNP);记录两组不良事件发生情况。结果:两组治疗前LVEF、LVEDD、BNP、PLT、cTnI比较,差异均无统计学意义(P>0.05),治疗1、6个月后两组LVEF、LVEDD、BNP、cTnI均较治疗前显著改善(P<0.05);治疗1个月后,观察组BNP、cTnI均低于对照组(P<0.05),而两组LVEF、LVEDD及PLT比较,差异均无统计学意义(P>0.05);治疗6个月后,观察组LVEF高于对照组,LVEDD、BNP及cTnI均低于对照组,差异均有统计学意义(P<0.05),而两组PLT比较,差异无统计学意义(P>0.05)。观察组心血管不良事件发生率低于对照组(P<0.05);两组出血及呼吸困难发生率比较,差异均无统计学意义(P>0.05)。结论:与氯吡格雷相比,替格瑞洛可改善急性冠脉综合征非血运重建患者心功能,减少心血管不良事件发生且未增加出血事件,安全有效。

Objective:To compare the effects of Ticagrelor and Clopidogrel on the efficacy and adverse events of non-revascularization patients with acute coronary syndrome.Method:A total of 180 patients with ACS non-revascularization treated in Shenyang 245 Hospital from January 2018 to January 2021 were selected as the research objects.According to different treatment methods,the patients were divided into observation group(n=80)and control group(n=100).Both groups were treated with Aspirin.On this basis,the observation group was treated with Ticagrelor and the control group was treated with Clopidogrel.The left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD),platelet count(PLT),cardiac troponin(cTnI)and B-type brain natriuretic peptide(BNP)were recorded and compared between the two groups before treatment and 1,6 months after treatment.The adverse events of the two groups were recorded.Result:There were no significant differences in LVEF,LVEDD,BNP,PLT and cTnI between the two groups before treatment(P>0.05).LVEF,LVEDD,BNP and cTnI after 1 and 6 months of treatment were significantly improved compared with those before treatment in the two groups(P<0.05);after one month of treatment,BNP and cTnI in the observation group were lower than those in the control group(P<0.05),but there were no significant differences in LVEF,LVEDD and PLT between the two groups(P>0.05);after 6 months of treatment,LVEF in the observation group was higher than that in the control group,and LVEDD,BNP and cTnI were lower than those in the control group(P<0.05).There was no significant difference in PLT between the two groups(P>0.05).The incidence of cardiovascular adverse events in the observation group was lower than that in the control group(P<0.05);there were no significant differences in the incidences of bleeding and dyspnea between the two groups(P>0.05).Conclusion:Compared with Clopidogrel,Ticagrelor can improve cardiac function,reduce cardiovascular adverse events and do not increase bleeding events in patients with acute coronary syndrome undergoing non-revascularization.It is safe and effective.