多索茶碱治疗替格瑞洛相关呼吸困难的安全性及有效性分析

发布时间：2018-06-07 14:12

本文选题：替格瑞洛 + 呼吸困难　；参考：《郑州大学》2017年硕士论文

【摘要】：研究背景替格瑞洛是一种选择性P2Y12受体拮抗剂。作为一种新型药物,广泛应用于冠状动脉粥样硬化性心脏病患者抑制血小板聚集的治疗。PLATO研究指出,替格瑞洛与氯吡格雷在ACS患者中相比较,前者不仅能够更有效的减少心肌梗死及猝死的发生,而且在总体出血率方面,替格瑞洛并未增加风险。随着替格瑞洛在临床的普遍应用,与其相关的呼吸困难也越来越引起人们的关注。鉴于临床上应用替格瑞洛后呼吸困难发生率高,各研究资料中关于其相关治疗方法很少,且在临床上容易误诊误治,造成资源浪费,停药后使得患者临床获益减低,所以有必要寻找一种有效的药物治疗方法。目的探讨多索茶碱治疗冠心病患者替格瑞洛相关呼吸困难的安全性及有效性。方法入选2015年02月至2016年07月郑州大学第一附属医院心内科服用替格瑞洛后出现相关呼吸困难的冠心病患者200例,随机分为干预组及对照组。干预组给予多索茶碱片(商品名:安赛玛,规格:200mg/片)早晚各1片服用5天;对照组给予安慰剂。记录两组1天后呼吸困难总缓解率,治疗前后血小板聚集率以及6个月心源性死亡、心肌梗死、卒中、出血等心血管不良事件(MACE)的发生率。结果1.应用多索茶碱1天后干预组呼吸困难总缓解率为93.0%,对照组为62.8%,两组呼吸困难总缓解率差异有统计学意义(P0.05)。2.服用多索茶碱前干预组血小板聚集率为:35.53±5.1(%),对照组血小板聚集率为35.16±4.6(%),两组血小板聚集率无统计学差异(P0.05)。3.服用多索茶碱5天后干预组血小板聚集率为:26.48±4.3(%),对照组血小板聚集率为:25.98±4.7(%),差异无统计学意义(P0.05)。4.两组6个月心源性死亡、心肌梗死、卒中、出血等心血管不良事件(MACE)的发生率无差异(P0.05)。结论多索茶碱治疗替格瑞洛相关呼吸困难有效,并且不影响替格瑞洛抗血小板聚集作用。
[Abstract]:Background tigrillo is a selective P2Y12 receptor antagonist. As a new drug, widely used in patients with coronary atherosclerotic heart disease, inhibition of platelet aggregation. PLATO study shows that tigrilol and clopidogrel were compared in ACS patients. The former not only significantly reduced the incidence of myocardial infarction and sudden death, but also did not increase the risk of overall bleeding. With the wide application of tigrillo in clinical practice, dyspnea associated with it has attracted more and more attention. In view of the high incidence of dyspnea after the application of tigrilol in clinic, there are few treatment methods related to it in various studies, and it is easy to be misdiagnosed and mistreated clinically, resulting in a waste of resources, and the clinical benefits of patients are reduced after withdrawal of the drug. Therefore, it is necessary to find an effective drug treatment. Objective to investigate the safety and efficacy of doxofylline in the treatment of tigrilo-associated dyspnea in patients with coronary heart disease. Methods from February 2015 to July 2016, 200 patients with coronary heart disease associated with dyspnea in the Department of Cardiology, the first affiliated Hospital of Zhengzhou University, were randomly divided into two groups: intervention group and control group. The intervention group was given doxotheophylline tablets (trade name: Ansama, size: 200 mg / tablet) in the morning and evening, and the control group was given placebo. The total remission rate of dyspnea, the platelet aggregation rate before and after treatment and the incidence of cardiac death, myocardial infarction, stroke, hemorrhage and other adverse cardiovascular events in the two groups were recorded. Result 1. The total remission rate of dyspnea was 93.0 in the intervention group and 62.8 in the control group one day after the administration of doxofylline. The difference between the two groups was statistically significant (P 0.05). The platelet aggregation rate of the intervention group was 35.53 卤5.1 before the administration of doxofylline, while that of the control group was 35.16 卤4.6. There was no significant difference in the platelet aggregation rate between the two groups. After taking doxotheophylline for 5 days, the platelet aggregation rate of intervention group was 26.48 卤4.3 and that of control group was 25. 98 卤4. 7. There was no significant difference in platelet aggregation rate between two groups. There was no significant difference in the incidence of cardiac death, myocardial infarction, stroke, hemorrhage and other adverse cardiovascular events between the two groups in 6 months (P 0.05). Conclusion doxofylline is effective in the treatment of tigrilo-associated dyspnea and has no effect on platelet aggregation.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R541.4

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