替格瑞洛与氯吡格雷治疗冠心病心肌缺血的效果对比研究

目的 探讨替格瑞洛与氯吡格雷在冠心病心肌缺血患者中的应用效果。方法 于本院心内科2018 年6 月～2019 年9 月收诊的冠心病心肌缺血患者中选出155 例为研究对象，根据患者的用药方案分成替格瑞洛组（n=77，心内科综合治疗+替格瑞洛治疗）和氯吡格雷组（n=78，心内科综合治疗+氯吡格雷治疗），收集两组患者的总有效率、血液流变学等。结果 替格瑞洛组患者治疗总有效率（96.10%）高于氯吡格雷组患者的治疗总有效率（82.05%），差异有统计学意义（P＜0.05）；替格瑞洛组患者治疗后的血浆黏度、全血低切黏度、红细胞聚集指数以及血小板聚集率均显著低于氯吡格雷组，差异有统计学意义（P＜0.001）；替格瑞洛组患者的心血管事件发生率（5.19%）低于氯吡格雷组患者心血管事件发生率（16.67%），差异有统计学意义（P＜0.05）；替格瑞洛组患者的出血事件发生率（7.79%）略高于氯吡格雷组患者的出血事件发生率（7.13%），但差异无统计学意义（P＞0.05），且两组出血事件均较轻微，未影响疗程。结论 替格瑞洛在冠心病心肌缺血患者中应用疗效优于氯吡格雷，有助于改善微循环，缓解心肌缺血症状，且不会增加出血风险，安全性较高，值得推广。

Comparative study on the efficacy of ticagrelor and clopidogrel on myocardial ischemia in patients with coronary heart disease

Objective To investigate the application efficacy of ticagrelor and clopidogrel on myocardial ischemia in patients with coronary heart disease.Methods A total of 155 patients with myocardial ischemia of coronary heart disease admitted to our hospital from June 2018 to September 2019 were selected as the research objects,and they were divided into the ticagrelor group(n=77,comprehensive treatment of cardiology combined with ticagrelor treatment) and the clopidogrel group(n=78,comprehensive treatment of cardiology combined with clopidogrel treatment) according to their medication schemes.The total efficacy rates and hemorheology of the two groups were collected.Results The total efficacy rate of the ticagrelor group was 96.10%,which was higher than 82.05% of the clopidogrel group,and the difference was statistically significant(P<0.05).After treatment,the plasma viscosity,low shear blood viscosity,erythrocyte aggregation index and platelet aggregation rate of patients in the ticagrelor group were significantly lower than those in the clopidogrel group,and the differences were statistically significant(P<0.001).The incidence of cardiovascular events in the ticagrelor group was 5.19%,which was lower than 16.67% in the clopidogrel group,and the difference was statistically significant(P<0.05).The incidence of bleeding events in the ticagrelor group was 7.79%,which was slightly higher than 7.13% in the clopidogrel group,but there was no significant difference between the two groups(P>0.05),and the bleeding events in both groups were mild and did not impact the course of treatment.Conclusion Ticagrelor has better therapeutic efficacy than clopidogrel in patients with myocardial ischemia of coronary heart disease,which is helpful to improve microcirculation and relieve myocardial ischemia symptoms without increasing the risk of bleeding.It is safe and worthy of promotion.