替格瑞洛联合瑞替普酶治疗急性ST段抬高型心肌梗死的疗效和安全性

发布时间：2018-05-21 04:45

本文选题：替格瑞洛 + 瑞替普酶　；参考：《中国新药杂志》2017年12期

【摘要】：目的:探讨替格瑞洛联合瑞替普酶静脉溶栓治疗急性ST段抬高心肌梗死(ST-segment elevation myocardial infarction,STEMI)的疗效和安全性,为临床安全用药提供依据。方法:回顾性分析山东大学附属临沂市人民医院2013年3月—2014年12月67例行静脉溶栓治疗的STEMI患者临床资料,将接受替格瑞洛联合瑞替普酶治疗的患者作为研究组(n=32),接受氯吡格雷联合阿替普酶治疗的患者为对照组(n=35)。比较两组患者的临床特征、冠心病监护病房(CCU)治疗天数、血管再通率、梗死后心绞痛发生率、心力衰竭发生率、心源性死亡发生率、出血事件和呼吸困难发生率等。结果:溶栓后30,60,90和120 min研究组临床判断血管再通率均高于对照组;60 min时研究组和对照组再通率分别为65.6%和34.3%,差异有统计学意义(P=0.020);120 min时研究组和对照组再通率分别为93.8%和74.3%,差异有统计学意义(P=0.032)。研究组和对照组住院期间梗死后心绞痛发生率分别为12.50%和31.43%;心力衰竭发生率分别为6.26%和11.43%;心源性死亡分别为3.13%和5.71%,差异均无统计学意义(P0.05);CCU治疗天数分别为(4.53±1.48)和(5.26±1.34)d,差异有统计学意义(P=0.04);两组出血事件发生率相当,研究组重度出血发生率9.38%,对照组未发生重度出血;对照组呼吸困难发生率6.25%,研究组未发生呼吸困难,差异均无统计学意义(P0.05)。结论:瑞替普酶联合替格瑞洛治疗STEMI疗效显著,但可能会增加重度出血的风险,需要恰当选择适应证、扩大研究样本进一步证实疗效和安全性。
[Abstract]:Objective: to investigate the efficacy and safety of tigrilol combined with reteprase in the treatment of ST-segment elevation myocardial inflexion in patients with acute ST-segment elevation myocardial infarction. Methods: the clinical data of 67 STEMI patients who received intravenous thrombolytic therapy from March 2013 to December 2014 in Linyi people's Hospital affiliated to Shandong University were analyzed retrospectively. Patients who received tigrilol combined with reteprase as study group were treated with clopidogrel combined with atropinase, and patients with clopidogrel combined with atropase were treated as control group (n = 35). The clinical characteristics, the days of CCU treatment, the rate of recanalization, the incidence of angina pectoris after infarction, the incidence of heart failure, the incidence of cardiac death, the incidence of bleeding events and dyspnea were compared between the two groups. Results: the recanalization rate in the study group was higher than that in the control group and the control group at 60 min after thrombolysis. The difference was statistically significant at P0.020 min and control group, respectively. 93.8% and 74.3%, the difference was statistically significant. The incidence of angina pectoris in the study group and control group was 12.50% and 31.43%, the incidence of heart failure was 6.26% and 11.43 respectively, the cardiac death rate was 3.13% and 5.71%, the difference was not statistically significant (P 0.05 卤1.48) and 5.26 卤1.34 days, respectively. The difference was statistically significant (P < 0.05), and the incidence of bleeding events was similar between the two groups. The incidence of severe hemorrhage in the study group was 9.38, and that in the control group was not severe. In the control group, the incidence of dyspnea was 6.25, and there was no dyspnea in the study group (P 0.05). Conclusion: Retiprase combined with tigrilol is effective in the treatment of STEMI, but it may increase the risk of severe hemorrhage. It is necessary to select appropriate indications and to expand the study sample to further confirm the efficacy and safety.
【作者单位】：山东大学附属临沂市人民医院药学部;山东大学附属临沂市人民医院心内科;
【基金】：临沂市科技计划发展项目(201213033)
【分类号】：R542.22

【相似文献】