替格瑞洛在非氯吡格雷抵抗急性心肌梗死患者支架植入术后的应用

作者单位:111000 辽宁 辽阳,辽阳市第五人民医院内科

 心肌梗死;急性;替格瑞洛;氯吡格雷;支架植入术

Application of Tegrarol after Stent Implantation in Patients with Non-clopidogrel Resistant Acute Myocardial Infarction
HAN Bing

(Department of Internal Medicine, The Fifth People’s Hospital of Liaoyang, Liaoyang 111000, Liaoning Province, China)

 Myocardial Infarction; Acute; Tegrarol; Clopidogrel; Stent Implantation

DOI: 10.3969/j.issn.1672-7185.2020.06.012

备注

 目的  探讨替格瑞洛对非氯吡格雷抵抗急性心肌梗死(ACI)经皮冠状动脉介入术(PCI)治疗后的抗血小板凝聚治疗效果。方法  选择辽阳市第五人民医院2017—2019年收治的因A CI行P CI治疗的非氯吡格雷抵抗患者90例,随机分为观察组和对照组各45例。对照组采用阿司匹林联合氯吡格雷治疗,观察组采用阿司匹林联合替格瑞洛治疗,比较两组治疗6个月后的血液流变学指标和血栓标志物,统计随访期间两组心血管不良事件(MACE)发生率。结果  两组治疗后高切黏度、低切黏度、血浆黏度、基质金属蛋白酶-9、D-二聚体和瘦素差异有统计学意义(P<0.05)。随访期间,两组MACE发生率差异无统计学意义(P>0.05)。结论  对于非氯吡格雷抵抗的P CI术后患者,无论是替格瑞洛还是氯吡格雷均可有效发挥抗血小板凝聚作用,但是替格瑞洛在改善血液黏度和血栓方面具有一定优势,而且并未增加MACE发生情况。
 Objective  To investigate the effect of tegrilol on antiplatelet aggregation after percutaneous coronary intervention (PCI) for non clopidogrel resistant acute myocardial infarction (ACI). Methods  A total of 90 patients with non clopidogrel resistance, who were treated with PCI for ACI from 2017 to 2019, were randomly divided into the observation group and the control group(45 cases in each group). The control group was treated with aspirin and clopidogrel, and the observation group was treated with aspirin and tegrarol. The hemorheology indexes and thrombus markers were compared between the two groups after 6 months of treatment, and the incidence of adverse cardiovascular events (MACE) was counted during the follow-up period. Results  There were significant differences in high shear viscosity, low shear viscosity, plasma viscosity, matrix metalloproteinase-9, D-dimer and leptin between the two groups (P<0.05). During the follow-up period, there was no significant difference in the incidence of MACE between the two groups (P>0.05). Conclusion  For the patients with non clopidogrel resistance after PCI, Both tigril and clopidogrel can effectively play the role in anti platelet aggregation, but tigril has some advantages in improving blood viscosity and thrombus, and does not increase the incidence of MACE.