邵春丽,颜红兵,乔树宾,唐熠达,慕朝伟,赵汉军,华倚虹,卿平

• 1:中国医学科学院 北京协和医学院 国家心血管病中心 阜外心血管病医院冠心病中心 心血管疾病国家重点实验室

摘要(Abstract)：

目的观察阜外心血管病医院近6个月替格瑞洛临床应用和替格瑞洛相关呼吸困难的发生情况。方法收集阜外心血管病医院2014年5月至2014年10月使用替格瑞洛患者的资料,包括患者临床特征和替格瑞洛相关呼吸困难发生情况,比较替格瑞洛相关呼吸困难与无药物相关呼吸困难患者的临床特征。结果413例患者中男315例(76.3%),急性心肌梗死患者215例(52.1%),冠状动脉造影明确为左主干和(或)多支病变患者334例(80.9%),急慢性闭塞病变患者128例(31.0%),左主干狭窄>50%患者37例(9.0%)。替格瑞洛相关呼吸困难患者26例(6.3%),其中停药患者2例(0.5%)。替格瑞洛相关呼吸困难患者与无药物相关呼吸困难患者相比,年龄差异有统计学意义[(58.3±6.5)岁比(57.3±11.6)岁,P=0.002];性别、高血压病、糖尿病、高脂血症、冠状动脉病变严重程度等比较,差异无统计学意义(均P>0.05)。结论替格瑞洛主要用于急性冠状动脉综合征和冠状动脉复杂病变经皮冠状动脉介入治疗高危患者,6.3%的患者发生替格瑞洛相关呼吸困难,仅少数患者需要停药。

关键词(KeyWords)： 替格瑞洛;替格瑞洛相关呼吸困难

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 邵春丽,颜红兵,乔树宾,唐熠达,慕朝伟,赵汉军,华倚虹,卿平

参考文献(References)：

• [1]Storey RF,Angiolillo DJ,Patil SB,et al.Inhibitory effects of ticagrelor compared with clopidogrel on platelet function in patients with acute coronary syndromes:the PLATO(Platelet Inhibition and Patient Outcomes)PLATELET substudy.J Am Coll Cardiol,2010,56:1456-1462.
• [2]马颖艳,王艳霞,徐白鸽,等.替格瑞洛用于经皮冠状动脉介入治疗术后患者抗血小板治疗短期内的有效性和安全性研究.中国介入心脏病学杂志,2014,22:380-383.
• [3]Wallentin L,Becker RC,Budaj A,et al.Ticagrelor versus clopidogrel in patients with acute coronary syndromes.N Engl J Med,2009,361:1045-1057.
• [4]Gurbel PA,Blinden KP,Butler K,et al.Response to ticagrelorin clopidogrelnonresponders and responders and effectof switching therapies:the RESPOND Study.Circulation,2010,121:1188-1199.
• [5]Hamm CW,Bassand JP,Agewall S,et al.ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation:The Task Force for the management of acute coronary syndromes(ACS)in patients presenting without persistent ST-segment elevation of the European Society of Cardiology(ESC).Eur Heart J,2011,32:2999-3054.
• [6]Husted S,Emanuelsson H,Heptinstall S,et al.Pharmacodynamics,pharmacokinetics,and safety of the oral reversible P2Y12antagonist AZD6140 with aspirin in patients with atherosclerosis:a double-blind comparison to clopidogrel with aspirin.Eur Heart J,2006,27:1038-1047.
• [7]Cannon CP,Husted S,Harrington RA,et al.Safety,tolerability,and initial efficacy of AZD6140,the first reversible oral adenosine diphosphate receptor antagonist,compared with clopidogrel,in patients with non-ST-segment elevation acute coronary syndrome:primary results of the DISPERSE-2 trial.J Am Coll Cardiol,2007,50:1844-1851.
• [8]Gaubert M,Laine M,Richard T,et al.Effect of ticagrelor-related dyspnea on compliance with therapy in acute coronary syndrome patients.Int J Cardiol,2014,173:120-121.
• [9]Storey RF,Bliden KP,Patil SB,et al.Incidence of dyspnea and assessment of cardiac and pulmonary function in patients with stable coronary artery disease receiving ticagrelor,clopidogrel,or placebo in the ONSET/OFFSET study.J Am Coll Cardiol,2010,56:185-193.
• [10]Cattaneo M,Faioni EM.Why does ticagrelor induce dyspnea?Thromb Haemost,2012,108:1031-1036.
• [11]朱永宏,贾国良,周妙,等.替格瑞洛治疗41例急性冠状动脉综合征患者的临床疗效.中国介入心脏病学杂志,2013,21:374-376.
• [12]Storey RF,Becker RC,Harrington RA,et al.Characterizationof dyspnoea in PLATO study patients treated with ticagreloror clopidogrel and its association with clinical outcomes.Eur Heart J,2011,32:2945-2953.