国内使用氯吡格雷与替格瑞洛治疗急性冠脉综合征的疗效及安全性分析

目的：分析比较氯吡格雷与替格瑞洛治疗急性冠脉综合征（ACS）的临床有效性以及安全性差别，为ACS抗血小板药物的选择提供合理参考。方法：计算机检索中国知网，万方以及维普三个中文数据库，获得国内公开发表的相关文献，统计分析各篇文献的有效性评测指标、疗效差别、不良反应以及不良事件发生情况等数据，比较氯吡格雷与替格瑞洛治疗ACS的有效性与安全性。结果：共纳入52篇有效文献，涉及病例7 839例。有效性方面，更多的证据提示替格瑞洛临床疗效优于氯吡格雷。主要不良心血管事件（MACE）方面，替格瑞洛组比氯吡格雷组MACE发生更少。2组出血事件发生率无统计学差异，在导致轻度呼吸困难方面替格瑞洛表现不及氯吡格雷。结论：在常规治疗基础上，替格瑞洛比氯吡格雷治疗ACS效果更为明显。除轻度呼吸困难外，安全性不劣势于氯吡格雷，临床可以考虑推广使用。

Analysis on efficacy and safety of ticagrelor versus clopidogrel in treatment of acute coronary syndrome

OBJECTIVE To evaluate the efficacy and safety of ticagrelor versus clopidogrel in patients with acute coronary syndrome.METHODS The databases of CNKI, Wanfang and VIP were retrieved for collecting relevant thesis about comparison of efficacy and safety of ticagrelor versus clopidogrel in treatment of ACS. Then the clinical data were extracted and analyzed.RESULTS Totally 52 articles were included, involving 7 839 cases. In respect of efficacy, more evidence suggested that ticagrelor was superior to clopidogrel. For MACE, the ticagrelor group was a much less incidence than that in clopidogrel group. There was no significant difference in the incidence of bleeding between two groups. Ticagrelor was inferior to clopidogrel in mild dyspnea.CONCLUSION With the routine treatment, the efficacy of ticagrelor is superior to clopidogrel in treatment of ACS. Except for mild dyspnea, the safety performance of ticagrelor is not inferior to clopidogel. In summary, ticagrelor has a certain clinical application value.