替格瑞洛与氯吡格雷对急性冠脉综合征患者经皮冠脉动脉介入术后血小板抑制效果的比较

目的:比较替格瑞洛与氯吡格雷对急性冠脉综合征(ACS)患者经皮冠脉动脉介入术(PCI)后血小板的抑制效果。方法:选择2014年3月至8月在我院经替格瑞洛联合阿司匹林治疗的ACS患者85例(替格瑞洛组),按性别、年龄2:1匹配原则随机抽取同一时间服用氯吡格雷联合阿司匹林治疗患者170例(氯吡格雷组)为研究对象,两组患者均行PCI治疗,并于服用抗血小板药物负荷剂量2天(PCI术后)进行血栓弹力图(TEG)检测,观察和比较两组患者经ADP途径及经AA途径的血小板抑制率。结果:氯吡格雷组和替格瑞洛组经ADP途径的血小板抑制率分别为(66.60±25.57)%、(82.10±18.87)%,两组比较差异有统计学意义(P0.05)。氯吡格雷组ADP抑制率50%患者占总人数的29.4%,替格瑞洛组ADP抑制率50%的患者占总人数的10.6%,两组差异有统计学意义(P0.05),氯吡格雷组ADP抑制率75%者占总人数的41.8%;而替格瑞洛组ADP抑制率75%的患者占总人数的69.4%,两组抑制率差异也存在统计学意义(P0.05)。氯吡格雷组和替格瑞洛组经AA途径的血小板抑制率分别为(88.70±23.89)%、(90.32±18.09)%,两组比较差异无统计学意义(P0.05)。结论:替格瑞洛对ACS患者PCI术后血小板的抑制作用优于氯吡格雷。

Comparison of Ticagrelor with Clopidogrel in the Treatment of Patients withAcute Coronary Syndrome in Platelet Reactivity

Objective:To compare the inhibitory effect of ticagrelor and clopidogrel on the platelet of patients with acute coronarysyndrome(ACS) after percutaneous coronary artery intervention(PCI).Methods:255 cases of patients with ACS admitted in our hospitalfrom March 2014 to August 2014 were selected for this study, in which 85 cases were treated by ticagrelor and aspirin and the other 170cases were treated by clopidogrel and aspirin respectively. All the patients were given PCI treatment, and the thrombelastography(TEG)were detected 2 days after PCI and oral administration of load dosage of antiplatelet drugs, the latelet inhibition ratio through ADP andAA pathway were observed and compared between the two groups.Results:Adenosine diphosphate (ADP)-induced platelet inhibitionratio in clopidogrel group was (66.60± 25.57)%, which was (82.10± 18.87)%in the ticagrelor group and significantly higher than that ofthe clopidogrel group (P<0.05). Arachidonic acid(AA)-induced platelet inhibition ratio were (88.70± 23.89)%, (90.32± 18.09)% in theclopidogrel group and the ticagrelor group. There was no significant difference in the AA -induced platelet inhibition ratio between twogroups (P>0.05). The percentages of patients with ADP-induced platelet inhibition ratio<50% were 29.4%and 10.6% in the clopidogrelgroup and ticagrelor group, there were significant differences between two groups (P<0.05). The percentages of patients withADP-induced platelet inhibition ratio>75% were 41.8% and 69.4% in the clopidogrel group and the ticagrelor group, respectively, andthere were significant differences between the two groups (P<0.05).Conclusion:Ticagrelor had greater inhibitory effect on the patientswith ACS after PCI than Clopidogrel.