替格瑞洛对非ST段抬高急性冠脉综合征患者预后及血小板聚集率的影响

目的：探讨替格瑞洛对非ST段抬高急性冠脉综合征(NSTE-ACS)患者预后及血小板聚集率的影响。方法选择2013年6月至2014年12月在东莞市常平医院心内科住院的NSTE-ACS患者170例，将其按照随机数表法随机分为氯吡格雷组(85例，氯吡格雷+阿司匹林)和替格瑞洛组(85例，替格瑞洛+阿司匹林)，连续治疗24周。在治疗前及治疗后1周用比浊法测定两组患者的血小板聚集率。随访24周，观察两组患者的心血管事件发生率及出血事件发生率。结果治疗1周后，氯吡格雷组与替格瑞洛组患者的血小板聚集率分别为(54.8±5.2)%与(47.6±4.9)%，两组患者的血小板聚集率与治疗前(60.4±5.8)%、(62.1±6.5)%]比较显著降低(P<0.05)，且替普瑞洛组的血小板聚集率下降幅度明显大于氯吡格雷组，差异均有统计学意义(P<0.05；随访24周期间，氯吡格雷组与替格瑞洛组心血管事件发生率分别为27.1%(23/85)与12.9%(11/85)，差异有统计学意义(P<0.05)。氯吡格雷出血事件发生率为3.53%(3/85)，替格瑞洛组为5.88%(5/85)，两组比较差异无统计学意义(P>0.05)。结论替格瑞洛可以明显降低血小板聚集率，具有比氯吡格雷更强的抗血小板聚集作用，能够降低NSTE-ACS患者心血管事件发生率，且出血并发症无明显增加。

Effects of ticagrelor on prognosis and platelet aggregation ratio in patients with non-ST-segment elevation acute ;coronary syndrome

Objective To investigate the effects of ticagrelor on prognosis and platelet aggregation ratio in pa-tients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS). Methods A total of 170 patients with NSTE-ACS in the Department of Cardiology, Changping Hospital of Dongguan from June 2013 to December 2014 were randomly divided into clopidogrel group (85 cases, treated with clopidogrel and aspirin) and ticagrelor group (85 cases, ti-cagrelor and aspirin) for continuous treatment of twenty-four weeks. Platelet aggregation ratio was determined by turbidim-etry for both groups before treatment and one week after treatment. The patients were followed up for twenty-four weeks. The incidence of cardiovascular events and bleeding events were observed in both groups of patients. Results One week after treatment, platelet aggregation ratio were (54.8 ± 5.2)% in clopidogrel group and (47.6 ± 4.9)% in ticagrelor group, which were both significantly lower than those before treatment (60.4±5.8)%, (62.1±6.5)%, P<0.05]. The reduc-tion of platelet aggregation ratio were significantly greater in ticagrelor group than that in clopidogrel group, and the dif-ference was statistically significant (P<0.05). During the follow-up of twenty-four weeks, the incidence of cardiovascu-lar events were 27.1%(23/85) in clopidogrel group and 12.9%(11/85) in ticagrelor group, with statistically significant difference (P<0.05). The incidence of bleeding was 3.53% (3/85) in clopidogrel group and 5.88% (5/85) in ticagrelor group, with no statistically significant difference between the two groups (P>0.05). Conclusion Ticagrelor can significant-ly decrease the platelet aggregation ratio. The effect of ticagrelor on anti-platelet aggregation is stronger than clopidogrel. Ti-cagrelor can reduce the incidence of cardiovascular events in patients with NSTE-ACS, and do not increase bleeding.