陈曦,石理,李军,朱媛,吴同果

• 1:暨南大学附属珠海医院珠海市人民医院心内科
• 2:珠海市第二人民医院心内科
• 3:暨南大学附属红会医院心内科

摘要(Abstract)：

目的探讨经皮冠状动脉介入治疗(PCI)术后低体重患者替格瑞洛联合不同剂量西洛他唑抗血小板治疗的疗效与安全性。方法纳入体重≤65 kg,阿司匹林不耐受的急性冠状动脉综合征(ACS)患者148例随机分为四组,即氯吡格雷分别联合西洛他唑50 mg组(CC50 mg组)和西洛他唑100 mg组(CC100 mg组),以及替格瑞洛分别联合西洛他唑50 mg组(TC50 mg组)和西洛他唑100 mg组(TC100 mg组)。分别于治疗后第7天和第30天检测血小板聚集程度比较分析。随访6个月,观察主要不良心血管事件发生率。结果治疗后第7天检测血小板聚集程度,TC 100 mg组花生四烯酸(AA)诱导的血小板聚集程度明显低于CC50 mg组、CC100 mg组、TC50 mg组[(0.71±0.63)比(1.22±0.79),P=0.029、[(0.71±0.63)比(1.03±0.65),P=0.031]、[(0.71±0.63)比(1.11±1.02),P=0.034];TC50 mg组腺苷二磷酸(ADP)诱导的血小板聚集程度显著低于CC50 mg组[(2.03±2.50)比(3.23±2.60),P=0.025];TC100 mg组ADP诱导的血小板聚集程度明显低于CC50 mg组、CC100 mg组、TC50 mg组[(1.86±1.24比(3.23±2.60),P=0.018](1.86±1.24)比(3.09±2.12),P=0.019]、[(1.86±1.24)比(2.03±2.50),P=0.012],差异均有统计学意义。第30天复查血小板聚集程度,TC100 mg组AA诱导的血小板聚集程度明显低于CC50 mg组、CC100 mg组、TC50 mg组[(0.82±0.76)比(1.26±0.87),P=0.021]、[(0.82±0.76)比(1.15±0.66),P=0.028]、[(0.82±0.76)比(1.11±0.79),P=0.031];TC50 mg组ADP诱导的血小板聚集程度显著低于CC50 mg组[(2.04±1.70)比(3.03±1.98),P=0.027];TC100 mg组ADP诱导的血小板聚集程度明显低于CC50 mg组、CC100 mg组、TC50 mg组[(1.78±1.07)比(3.03±1.98),P=0.007]、[(1.78±1.07)比(2.09±1.52),P=0.009]、[(1.78±1.07)比(2.04±1.70),P=0.009],差异均有统计学意义。随访6个月,主要不良心血管事件发生率,四组比较,差异无统计学意义。总出血事件比较,CC50 mg组总出血风险低于其他三组,差异无统计学意义。结论低体重(≤65 kg)ACS患者PCI术后抗血小板治疗,替格瑞洛联合西洛他唑50 mg抗血小板治疗安全有效,且出血风险小。

关键词(KeyWords)： 经皮冠状动脉介入治疗;替格瑞洛;西洛他唑;急性冠状动脉综合征

Abstract:

Keywords:

基金项目(Foundation): 广东省科学技术厅课题(2010B080702010)

作者(Author): 陈曦,石理,李军,朱媛,吴同果

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