李志华,张亚臣,解玉泉,张燚,徐琛华,相银,吴红,陈漫天,孟舒,沈成兴

• 1:上海交通大学医学院附属新华医院心血管内科

摘要(Abstract)：

目的探讨经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后的急性冠状动脉综合征(acute coronary syndrome,ACS)患者应用替格瑞洛的临床疗效和安全性。方法纳入ACS并行PCI的患者1200例,随机分为氯吡格雷组(600例)和替格瑞洛组(600例)。随访6个月,观察并记录患者的主要不良心血管事件(包括心原性死亡、支架内血栓形成、心力衰竭、再次血运重建、再发心肌梗死)、出血及一般不良反应的发生情况。结果口服负荷剂量药物后2、24、48 h,替格瑞洛组血小板抑制率均明显高于氯吡格雷组(均P<0.05)。随访期间,两组均未发生死亡、大出血事件。替格瑞洛组主要终点事件发生率低于氯吡格雷组(1个月:0比0.2%,P=0.816;3个月:10.5%比13.1%,P=0.506;6个月:6.9%比9.8%,P=0.447),出血率稍高于氯吡格雷组(1个月:13.5%比12.8%,P=0.836;3个月:12.8%比11.5%,P=0.825;6个月:11.6%比11.4%,P=0.818)。术后1个月替格瑞洛组呼吸困难发生率稍高于氯吡格雷组(4.3%比3.3%,P=0.310),两组术后3、6个月呼吸困难例数均明显减少,且差异无统计学意义(均P>0.05)。两组间1、3、6个月的皮疹发生率比较,差异均无统计学意义(均P>0.05)。结论替格瑞洛较氯吡格雷在ACS患者PCI术后应用的抗血小板聚集作用起效更快更强,且两者的安全性相当。

关键词(KeyWords)： 替格瑞洛;氯吡格雷;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):

作者(Author): 李志华,张亚臣,解玉泉,张燚,徐琛华,相银,吴红,陈漫天,孟舒,沈成兴

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