汪敏,双东思,苏晞

• 1:武汉亚洲心脏病医院心内科

摘要(Abstract)：

目的比较急性冠状动脉综合征(acute coronary syndrome,ACS)合并2型糖尿病患者应用氯吡格雷和替格瑞洛的残余血小板高反应性及对预后的影响。方法选取武汉亚洲心脏病医院2013年3月至2015年3月住院的ACS合并2型糖尿病患者175例,入院后均给予标准双联抗血小板治疗,分为氯吡格雷组(153例)和替格瑞洛组(22例)。采用光比浊法测量腺苷二磷酸诱导的血小板聚集率。定义血小板最大聚集率>46.0%为残余血小板高反应性。比较两组残余血小板高反应性的差异及残余血小板高反应性对3个月预后的影响。结果氯吡格雷组残余血小板高反应性的发生率显著高于替格瑞洛组,差异有统计学意义[64.7%(99/153)比36.4%(8/22),P=0.011]。随访3个月,残余血小板高反应组发生支架内血栓事件3例(2.8%,3/107),均发生于使用氯吡格雷患者,残余血小板正常反应组无一例发生,两组的差异有统计学意义(P=0.016);两组患者的主要事件复合终点、全因死亡、心肌梗死、卒中、出血事件等发生率分别比较,差异均无统计学意义(均P>0.05)。结论 ACS合并2型糖尿病患者应用替格瑞洛较氯吡格雷显著降低治疗后的残余血小板高反应性,残余血小板高反应性增加支架内血栓风险。

关键词(KeyWords)： 急性冠状动脉综合征;2型糖尿病;氯吡格雷;替格瑞洛;残余血小板高反应性

Abstract:

Keywords:

基金项目(Foundation): 武汉市卫计委课题(WX14C78)

作者(Author): 汪敏,双东思,苏晞

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