替格瑞洛在急性冠状动脉综合征使用中的安全性及不良反应观察

Safety and adverse reactions of ticagrelor on patients with acute coronary syndrome

目的观察替格瑞洛在急性冠状动脉综合征(acute coronary syndrome,ACS)患者应用中的安全性和不良反应发生情况。方法选取2014年1月—2015年6月193例山西省心血管病医院收治的急性冠状动脉综合征患者,所有患者均给予替格瑞洛及阿司匹林治疗,观察并记录患者出院1年内的主要不良心脑血管事件(包括心源性死亡、支架内血栓形成、再发心肌梗死、卒中)、出血情况及不良反应的发生情况。结果随访1年内未发生大出血、支架内血栓、再次心肌梗死事件,共出现气短34例,脑基底节区出血(3 ml)1例,皮肤散在出血点12例,牙龈出血6例,鼻出血4例,死亡1例(具体原因不明)。结论替格瑞洛在ACS患者使用中是安全的,但在随访中发现出现呼吸困难的比例较高,需大样本随机对照研究进一步证实。

Objective To investigate the safety and adverse reaction of ticagrelor in patients with acute coronary syndrome(ACS). Methods Totally 193 cases of patients with ACS were enrolled in Shanxi Cardiovascular Hospital during the periond of January 2014—June 2015. They all received ticagrelor and aspirin. The main adverse cardiovascular and cerebrovascular events including cardiogenic death,stent thrombosis, recurrence of myocardial infarction and stroke, the occurrence of bleeding and general adverse reactions were observed. Results During the period of one year follow-up, there was no massive hemorrhage, stent thrombosis, myocardial infarction event. There were 34 cases of patients with shortness of breath, 1 case of patients with brain basal ganglia hemorrhage(3 ml), 12 cases of patients with scattered bleeder in skin, 6 cases of patients with gingival bleeding, 4 cases of patients with nasal bleeding. 1 case of patient was dead of specifically unknown reason. Conclusions Ticagrelor is safe in the treatment of patients with ACS, but the rate of dyspnea is high, and it needs further confirmation by large-scale randomized controlled trials.