李文铮,李世英,吴铮,吕媛,朱小玲,柳景华

• 1:首都医科大学附属北京安贞医院心内科北京心肺血管疾病研究所

摘要(Abstract)：

目的比较替格瑞洛和氯吡格雷对非ST段抬高急性冠状动脉综合征(acute coronary syndrome,ACS)患者经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)围术期高敏C反应蛋白(hs-CRP)和短期预后的影响。方法入选2013年10月至2014年3月因ACS入院的患者118例,随机给予替格瑞洛(60例,负荷剂量180 mg,维持剂量90 mg/次、每日2次)或氯吡格雷(58例,负荷剂量300 mg,维持剂量75 mg/次、每日1次)。观察PCI围术期hs-CRP变化和心肌肌钙蛋白I(c Tn I)及出院1个月不良事件发生情况。结果两组基线资料比较,差异无统计学意义。GRACE和CRUSADE危险评分显示,两组患者多为ACS缺血和出血低危患者。术后hs-CRP较术前升高的患者替格瑞洛组21例(35.00%),氯吡格雷组37例(63.79%),两组比较,差异有统计学意义(P=0.002)。PCI围术期心肌梗死替格瑞洛组10例(16.67%),氯吡格雷组9例(15.52%),两组比较,差异无统计学意义(P=0.865)。腺苷二磷酸(adenosine diphosphate,ADP)诱导的血小板聚集率替格瑞洛组显著低于氯吡格雷组[(20.55±9.74)%比(45.53±16.52)%,P=0.000]。两组随访心肌梗死、卒中、全因死亡和复合终点等不良终点事件发生率比较,差异均无统计学意义。结论对于低危非ST段抬高ACS患者,替格瑞洛较氯吡格雷可进一步显著降低PCI围术期hs-CRP升高率,提示替格瑞洛对围术期炎症可能具有抑制作用。

关键词(KeyWords)： 替格瑞洛;非ST段抬高急性冠状动脉综合征;经皮冠状动脉介入治疗

Abstract:

Keywords:

基金项目(Foundation): 北京市自然科学基金项目(7142048);; 国家重点基础研究发展计划(2015CB554404)

作者(Author): 李文铮,李世英,吴铮,吕媛,朱小玲,柳景华

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