急性冠脉综合征合并糖尿病患者经皮冠脉介入术后替格瑞洛与氯吡格雷的疗效比较

发布时间：2018-01-12 11:11

本文关键词：急性冠脉综合征合并糖尿病患者经皮冠脉介入术后替格瑞洛与氯吡格雷的疗效比较　出处：《中国医科大学学报》2016年02期 　论文类型：期刊论文

【摘要】：目的通过对糖尿病合并冠心病急性冠脉综合征行经皮冠脉介入术患者进行研究,比较替格瑞洛与氯吡格雷的疗效和安全性。方法选取我院拟行冠脉介入术治疗的糖尿病合并冠心病急性冠脉综合征患者120例,随机分为替格瑞洛组与氯吡格雷组。分别服用替格瑞洛180 mg负荷剂量之后90 mg每日2次与氯吡格雷300 mg负荷剂量之后75 mg每日1次维持,所有患者同时加服阿司匹林。入选患者均于服药前采集静脉血,测定血小板聚集率,并于7 d后再次抽血测定ADP诱导的血小板聚集率。观察患者在服药治疗6个月内各种心脑血管事件(包括心源性死亡、再发心肌梗死、支架内血栓形成、靶病变血管的再次重建、脑卒中)和并发症的发生情况。结果替格瑞洛组患者血小板聚集率明显低于氯吡格雷组(P0.05),出现不良心血管事件概率2组差异无统计学意义(P0.05),2组间的出血事件发生率差异无统计学意义(P0.05)。结论替格瑞洛治疗糖尿病合并冠心病冠脉介入术后患者能有效降低血小板聚集率,减少心血管事件发生,安全性较高。
[Abstract]:Objective to investigate the effect of percutaneous coronary intervention (PCI) on patients with acute coronary artery syndrome (ACS) complicated with diabetes mellitus (DM). To compare the efficacy and safety of tigrilol and clopidogrel. Methods 120 patients with diabetes mellitus complicated with acute coronary syndrome were selected for coronary intervention in our hospital. They were randomly divided into two groups: tigrilol group and clopidogrel group. 90 mg / d and 75 mg / d after tigrello 180 mg load and clopidogrel 300 mg load respectively. Mg was maintained once a day. All patients were given aspirin at the same time. The venous blood was collected before taking the medicine and platelet aggregation rate was measured. After 7 days, the platelet aggregation rate induced by ADP was determined again. All kinds of cardiovascular and cerebrovascular events (including cardiogenic death, recurrent myocardial infarction, and thrombosis in stent) were observed during 6 months of treatment. Results the platelet aggregation rate in tigride group was significantly lower than that in clopidogrel group (P 0.05). There was no significant difference in the incidence of adverse cardiovascular events between the two groups (P 0.05). There was no significant difference in the incidence of bleeding events between the two groups (P 0.05). Conclusion tigrilol can effectively reduce the platelet aggregation rate after coronary intervention in patients with diabetes mellitus and coronary heart disease. It is safe to reduce cardiovascular events.
【作者单位】：广东省佛山市第一人民医院心血管内科;广东省佛山市第一人民医院临床研究所;
【基金】：佛山市医学类科技攻关项目(2014AB00274)
【分类号】：R541.4;R587.1
【正文快照】： 近年来,随着人们生活方式及饮食习惯的改变、人口老龄化的加剧、社会生活压力的增加、冠心病的发病率逐年增加,成为威胁人类健康的第一大疾病,临床中冠心病急性冠脉综合征(acute coronarysyndrome,ACS)患者面临巨大的死亡风险[1]。经皮冠脉介入术(percutaneous coronary inter

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