摘要
目的 探讨三种抗血小板治疗方案对急性冠状动脉综合征冠状动脉多支病变行PCI术治疗的有效性及安全性.方法 选取急性冠状动脉综合征多支病变且行PCI术患者215例为研究对象,并根据不同的治疗方案将患者分为氯吡格雷高剂量组（试验A组,38例,术前顿服300 mg,术后每次150 mg,每日1次）,替格瑞洛组（试验B组,78例,术前顿服180mg,术后每次90 mg,每日2次）和氯吡格雷普通剂量组（对照组,99例,术前300 mg顿服,术后每次75 mg,每日1次）.术后均对患者随访12个月,比较三组患者基本临床资料、冠状动脉病变特征、药物使用情况、CYP2C19基因多态性及12个月内主要不良心血管事件、不良反应发生.结果 三组患者基本临床资料、冠状动脉病变特征、药物使用情况比较未见统计学差异（P＞0.05）,具有可比性.试验组中CYP2C 19基因型为中慢代谢型的患者的比例明显高于对照组,差异有统计学意义（P＜0.05）.试验B组患者随访期间（12个月内）MACE发生率显著低于对照组（7.7％比25.3％）,且低于试验A组（7.7％比21.1％）,差异有统计学意义（P＜0.05）;呼吸困难发生率、出血事件及总不良反应发生率三组比较未见统计学差异（P＞0.05）.结论 替格瑞洛较两种剂量氯吡格雷对急性冠状动脉综合征冠状动脉多支病变行PCI术患者具有良好的有效性及安全性.
Objective To compare the efficacy and safety of antiplatelet therapy of three antiplatelet therapies on patients suffering from acute coronary syndrome （ACS） with multivessel disease undergoing percutaneous coronary intervention （PCI）. Methods 215 patients of acute coronary syndrome with multivessel disease who received PCI were divided into high dose Clopidogrel group （Test group A, n=38, preoperative 300 mg loading, 150 mg after operative, once per day）, Ticagrelor group （Test group B, n=78, preoperative 180 mg loading, 90 mg after operative, two times per day） and ordinary Clopidogrel group （Control group, n=99, preoperative 300 mg loading, 75 mg alter operative, once per day）. The basic clinical data, laboratory results, therapeutic of drugs, coronary artery disease characteristics, CYP2C19 gene polymorphism and the major adverse cardiovascular events of the follow-up for 12 months and bleeding complications were observed and compared among the three groups. Results The basic clinical data, laboratory results, therapeutic of drugs, coronary artery disease characteristics had no statistical significance among three groups （P〉0.05）. In the test group, the ratio of CYP2Cl9 genotype to moderate and slow metabolic type was significantly higher than that of the control group, the difference was statistically significant （ P〈0.05 ）. The incidence of MACE in the test group B was significantly lower than that in the control group （7.7% vs. 25.3%, P〈0.05 ） within 12 month, and it was lower than that in test group A （7.7% vs. 21.1%, P〈0.05 ）. The three groups had no statistical significance in adverse reaction and bleeding complications （P〉0.05）. Conclusion Compared with Clopidogrel antiplatelet therapy of Ticagrelor on patients suffering from acute coronary syndrome with multivessel disease undergoing percutaneous coronary intervention has good efficacy and safety.
作者
李爽
夏豪
刘浙波
梁桂诚
LI Shuang;XIA HAO;LIU Zhe-bo(Department of Cardiology,the People＇s Hospital of Wuhan University,Wuhan 430060,Chin)
出处
《中国心血管病研究》
CAS
2018年第7期642-646,共5页
Chinese Journal of Cardiovascular Research
基金
国家自然科学基金项目(项目编号:81270184)
作者简介
通讯作者：夏豪，E—mail：xiahao1963@163．com
