【摘要】 目的探讨替格瑞洛在急性ST段抬高型心肌梗死(STEMI)行急诊经皮冠状动脉介入治疗(PCI)ICUB病人中的临床疗效及安全性。方法将200例STEMI行急诊PCI病人分为替格瑞洛及氯吡格雷组(n=100),分别予以替格瑞洛及氯吡格雷治疗,观察两组术后即刻冠脉无复流发生率、术后3个月主要心血管不良事件(MACE)、出血事件、血红蛋白、左室射血分数(LVEF)、血小板计数、药物不良反应。结果两组基础临床情况和造影特征无明显差异。替格瑞洛组在术后即刻冠脉无复流发生率明显低于氯吡格雷组,具有统计学意义(P=0.017),在术后3个月主要心血管事件低于氯吡格雷组,但无统计学意义,术后3个月出血事件高于氯吡格雷组,但无统计学意义。两组数据在术后3个月血红蛋白无明显统计学意义,替格瑞洛组血小板计数高于氯吡格雷组,具有统计学意义,在药物不良反应方面,替格瑞洛组高于氯吡格雷组,但无统计学意义(P=0.118),术后3个月LVEF替格瑞洛组高于氯吡格雷组(P=0.019)。结论急诊PCI术前负荷替格瑞洛要优于氯吡格雷,且有利于预后,可以减少MACE事件发生,替格瑞洛不良反应比氯吡格雷多见,但基本是安全的、可控的。更多还原

【Abstract】 Objective To explore the clinical efficacy and safety of ticagrelor in acute ST-segment elevation myocardial infarction( STEMI) underwent emergency percutaneous coronary intervention( PCI).Methods Two hundreds patients with STEMI underwent emergency PCI were randomly divided into two groups:ticagrelor group(n =100) treated with ticagrelor,and clopidogrel group(n = 100) treated with clopidogre for 3 months.The incidence of coronary no reflow,major adverse cardiovascular events( MACE),bleeding events,hemoglobin,left ventricular ejection fraction( LVEF),platelet count,adverse drug reactions were observed.Results The incidence of immediate coronary no reflow in ticagrelor group was obviously lower than that in clopidogrel group(P = 0.017).The incidence of MACE after 3 months in ticagrelor group was lower than that in clopidogrel group,but there was no difference between two groups(P >0.05).The incidence of bleeding events in ticagrelor group was higher than that in clopidogrel group,but there was no difference between two groups( P >0.05). There was no significant difference in hemoglobin between two groups(P >0.05).The platelet count in ticagrelor group was higher than that in clopidogrel group.The incidence of adverse drug reactions in ticagrelor group was higher than that in clopidogrel group,but there was no difference between two groups(P =0.118).LVEF in ticagrelor group was higher than that in clopidogrel group(P =0.019).Conclusion Loading for ticagrelor before emergency PCI is superior to clopidogrel,and is helpful for prognosis,can reduce MACE event occurs.It is safe and controlled.更多还原