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目的探讨替格瑞洛在急性冠脉综合征(ACS)患者应用的有效性与安全性。方法ACS患者180例随机均分为试验组(口服负荷量替格瑞洛180mg,维持量90mg,每天2次)与对照组(口服负荷量氯吡格雷300mg,维持量75mg,每天1次),随访治疗6个月时主要心血管事件及出血等不良反应的发生情况。结果随访6个月,试验组发生心源性或脑源性死亡、再发心肌梗死或心绞痛发生率低于对照组(P<0.05),但微小出血、呼吸困难、新发缓慢型心律失常发生率和血尿酸增高的比例均高于对照组(P<0.05)。两组间支架内血栓或支架内再狭窄、卒中或短暂性脑缺血及其他动脉栓塞和心律失常发生率、血肌酐及ALT增高比值差异无统计学意义(P>0.05)。结论与氯吡格雷比较,替格瑞洛治疗ACS具有更好的疗效,不良反应可以接受。
Objective To investigate the efficacy and safety of ticagrelor in patients with acute coronary syndrome (ACS). Methods 180 patients with ACS were randomly divided into test group (oral dose of ticagrelor 180mg, maintenance dose 90mg, twice a day) and control group (oral load of clopidogrel 300mg, maintenance dose 75mg once daily) Follow-up treatment of 6 months when the main cardiovascular events and bleeding and other adverse reactions. Results The patients were followed up for 6 months. Cardiac or brain-derived death occurred in the experimental group, and the incidence of recurrent myocardial infarction or angina pectoris was lower than that in the control group (P <0.05). However, mild bleeding, dyspnea and new-onset arrhythmia occurred The rates of increased blood uric acid and serum uric acid were higher than those of the control group (P <0.05). There was no significant difference in restenosis rate, restenosis or stroke, transient arterial embolism or arrhythmia, serum creatinine and ALT between the two groups (P> 0.05). Conclusion Compared with clopidogrel, ticagrelor treatment of ACS has better efficacy, adverse reactions can be accepted.