杨敏,姜祖超,王文尧,张璇,袁勋,张阔,陈静,唐熠达

• 1:中国医学科学院北京协和医学院国家心血管病中心阜外医院冠心病中心
• 2:东光县医院

摘要(Abstract)：

目的评价替格瑞洛与氯吡格雷对急性ST段抬高心肌梗死(STEMI)行直接经皮冠状动脉介入治疗(PCI)患者术后慢血流的影响。方法采用回顾性病例对照研究的方法,连续收集2014年4月至2015年2月阜外医院收治的急性STEMI直接PCI的患者共260例,根据PCI术前接受P2Y12受体抑制剂的不同分为替格瑞洛组(84例)和氯吡格雷组(176例)。比较两组PCI术后慢血流发生率及围术期出血发生情况,并对慢血流和围术期出血相关影响因素进行多因素Logistic回归分析。结果对于急性STEMI患者,替格瑞洛组PCI术后慢血流发生率低于氯吡格雷组(OR 0.333,95%CI 0.118~0.941,P<0.05);替格瑞洛组与氯吡格雷组PCI术后大出血和小出血发生率比较,差异均无统计学意义(OR 1.076,95%CI 0.484~2.389,P=0.857;OR 1.218,95%CI 0.688~2.156,P=0.500)。结论对于急性STEMI直接PCI的患者,替格瑞洛与氯吡格雷比较,可降低PCI术后慢血流发生率,且未增加围术期大出血和小出血的发生率。

关键词(KeyWords)： 急性ST段抬高心肌梗死;经皮冠状动脉介入治疗;替格瑞洛;氯吡格雷;冠状动脉慢血流

Abstract:

Keywords:

基金项目(Foundation): 首都卫生发展科研专项项目(2011-4003-03);; 北京市卫生科技成果与适宜技术推广项目(TG-2015-21)

作者(Author): 杨敏,姜祖超,王文尧,张璇,袁勋,张阔,陈静,唐熠达

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