急性冠状动脉综合征PCI 术后患者应用替格瑞洛的疗效分析

Influence of Ticagrelor on patients with acute coronary syndrome

摘要:

目的 探讨急性冠状动脉综合征（ACS）经皮冠状动脉介入治疗（PCI）术后患者应用替格瑞洛 的疗效。方法 选取2014 年5 月-2016 年5 月在该院接受PCI 治疗的90 例ACS 患者作为研究对象，采用随 机数字表法分为对照组和观察组，每组45 例。观察组应用替格瑞洛，对照组应用氯吡格雷，比较两组患者血 小板最大聚集率（MPAR）、可溶性白细胞分化抗原40 配体（sCD40L）、P2Y12 反应单位（PRU）、超敏C 反应蛋白（hs-CRP）、基质金属蛋白酶-9（MMP-9）、一氧化氮NO、内皮素-1（ET-1）水平。结果 经 抗血小板治疗后，观察组MPAR、sCD40L、PRU 水平低于对照组（P <0.05）；观察组hs-CRP、MMP-9、 ET-1 水平低于对照组（P <0.05），NO 水平高于对照组（P <0.05）。PCI 术后随访半年，两组患者未出现支架 血栓、心源性死亡及严重脏器出血；对照组不良事件发生率为11.11%（5/45），观察组为6.67%（3/45），差异 无统计学意义（P >0.05）。结论 ACS 患者PCI 术后应用替格瑞洛进行抗血小板治疗，可以更好地改善血小 板聚集程度，减轻血管内炎症反应，减少术后心脏不良事件的发生，值得临床推广应用。

Abstract:

Objective To explore the effect of Ticagrelor on patients after percutaneous coronary intervention (PCI) of acute coronary syndrome (ACS). Methods Ninety cases of ACS receiving PCI in our hospital between May 2014 and May 2016 were selected as the research subjects. They were divided into control group and observation group by random digital table, with 45 cases in each group. The observation group was given Ticagrelor and the control group received Clopidogrel. Maximum platelet aggregation rate (MPAR) and the level of plasma soluble leukocyte differentiation antigen 40 ligand (sCD40L), P2Y12 reaction unit (PRU), hypersensitive C-reactive protein (hs-CRP), matrix metalloproteinase 9 (MMP-9), nitric oxide (NO) and endothelin-1 (ET-1) were compared between the two groups. Results After antiplatelet therapy, the levels of MPAR, sCD40L, PRU, hs-CRP, MMP-9 and ET-1 in the observation group were statistically lower than those in the control group (P < 0.05); the level of NO in the observation group was higher than that in the control group (P < 0.05). After half a year of follow-up, there was no stent thrombosis, cardiac death or severe organ bleeding in the two groups; the incidence of adverse events in the control group was 11.11% (5/45), while that in the observation group was 6.67% (3/45), there was no significant difference between the two groups (P > 0.05). Conclusions For patients with ACS, antiplatelet therapy using Ticagrelor after PCI can better alleviate platelet aggregation, relieve intravascular inflammatory response and reduce postoperative cardiac adverse events. It is worthy of clinical application.