阿司匹林联合不同剂量替格瑞洛对冠状动脉粥样硬化性心脏病经皮冠状动脉介入治疗术后患者心血管不良事件发生率的影响
Effect of Aspirin combined with Different Doses of Ticagrelor on the Incidence of Adverse Cardiovascular Events in Patients with Coronary Heart Disease after Percutaneous Coronary Intervention
倪俊杰 1张妮1
作者信息
- 1. 苏州市张家港市第五人民医院药剂科,江苏苏州 215600
- 折叠
摘要
目的 探讨阿司匹林联合不同剂量替格瑞洛对冠状动脉粥样硬化性心脏病患者经皮冠状动脉介入治疗(PCI)术后心血管不良事件发生率的影响.方法 选取 2020 年 9 月至 2022 年 9 月于苏州市张家港市第五人民医院接受PCI手术患者220 例作为研究对象,采用单双号法随机分为大剂量组及小剂量组,每组 110 例.小剂量组给予阿司匹林联合小剂量替格瑞洛治疗,大剂量组采用阿司匹林联合大剂量替格瑞洛治疗.比较两组患者心脏功能,包括左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)及左心室收缩末期内径(LVESD);微循环恢复情况,包括冠状动脉血流储备(CFR)、微循环阻力指数(IMR);血小板功能,包括血小板最大聚集率(MPAR)、P2Y12 反应单位(PRU);心血管不良事件及出血事件发生情况.结果 治疗3 个月后两组LVESD、LVEDD较治疗前显著降低,LVEF显著升高,且大剂量组LVESD、LVEDD较小剂量组明显更低,LVEF较小剂量组明显更高,差异有统计学意义(P＜0.05);治疗 6 个月后两组IMR、CFR水平均显著高于治疗前(P＜0.05),且大剂量组IMR、CFR水平较小剂量组明显更高(P＜0.05);治疗3 个月后两组PRU、MPAR水平均显著低于治疗前(P＜0.05),且大剂量组PRU、MPAR水平较小剂量组显著更低(P＜0.05);治疗 1 年内两组心血管不良事件发生率比较差异无统计学意义(P＞0.05);治疗1 年内大剂量组出血事件发生率明显高于小剂量组(P＜0.05).结论 阿司匹林联合大剂量替格瑞洛用于冠状动脉粥样硬化性心脏病PCI术后患者可有效改善心脏功能及冠状动脉血液循环,抑制血小板聚集,但出血事件发生风险较联合小剂量替格瑞洛更高,临床应根据患者具体情况选定用药剂量.
Abstract
Objective To explore the effect of aspirin combined with different doses of ticagrelor on the incidence of adverse cardiovascular events in patients with coronary heart disease after percutaneous coronary intervention(PCI).Methods A total of 220 patients who received PCI surgery in the Fifth People's Hospital of Zhangjiagang City,Suzhou from September 2020 to September 2022 were selected as the study objects,and were randomly divided into high-dose group and low-dose group by odd-even number method,with 110 cases in each group.The low-dose group was treated with aspirin combined with low-dose ticagrelor,and the high-dose group was treated with aspirin combined with high-dose ticagrelor.The cardiac function,including left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD)and left ventricular end-systolic diameter(LVESD);Microcirculation recovery,including coronary flow reserve(CFR)and microcirculation resistance index(IMR);Platelet function,including platelet maximum focusing ratio(MPAR)and P2Y12 response unit(PRU);Cardiovascular adverse events and bleeding events of the two groups were compared.Results After 3 months of treatment,LVESD and LVEDD were significantly decreased and LVEF was significantly increased in both groups,and LVESD and LVEDD were significantly lower and LVEF was significantly higher in high-dose group than those in low-dose group,the difference was statistically significant(P＜0.05).After 6 months of treatment,the levels of IMR and CFR in two groups were significantly higher than before treatment(P＜0.05),and the levels of IMR and CFR in high-dose group were significantly higher than those in low-dose group(P＜0.05).After 3 months of treatment,PRU and MPAR levels in two groups were significantly lower than before treatment(P＜0.05),and PRU and MPAR levels in high-dose group were significantly lower than those in low-dose group(P＜0.05).There was no significant difference in the incidence of adverse cardiovascular events between the two groups within 1 year of treatment(P＞0.05).The incidence of bleeding events in high-dose group was significantly higher than that in low-dose group(P＜0.05).Conclusion Aspirin combined with high-dose ticagrelor can effectively improve the cardiac function and coronary blood circulation and inhibit the platelet aggregation in patients with coronary heart disease after PCI,but it has higher risk of bleeding event than that of low-dose ticagrelor.It is necessary to select clinical dosage according to individual conditions of patients.
关键词
阿司匹林/替格瑞洛/剂量/冠状动脉粥样硬化性心脏病/经皮冠状动脉介入治疗/心血管不良事件Key words
Aspirin/Ticagrelor/Dose/Coronary heart disease/Percutaneous coronary intervention/Cardiovascular adverse events引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
万方数据