替格瑞洛治疗行PCI的ST段抬高型心肌梗死合并糖尿病患者效果观察

目的:观察行PCI治疗的ST段抬高型心肌梗死(STEMI)合并2型糖尿病(DM)患者应用替格瑞洛的有效性与安全性。方法:STEMI合并2型糖尿病患者154例,随机分为替格瑞洛组79例,氯吡格雷组75例,比较分析2组治疗1,6,12个月时全因死亡率、不良心血管事件(MACE)发生率、支架内血栓发生率、左室射血分数、出血事件及呼吸困难等指标。采用血栓弹力图检测2组患者治疗5 d时血小板抑制率和抵抗率。结果:替格瑞洛组1,6,12个月时全因病死率、MACE发生率、支架内血栓发生率较氯吡格雷组比较差异无统计学意义(P>0.05);替格瑞洛组支架内再狭窄发生率低于氯吡格雷组,左室射血分数优于氯吡格雷组(P<0.05);替格瑞洛组呼吸困难发生率高于氯吡格雷组(P<0.05),但症状轻微,无需特殊治疗;2组出血事件发生率比较差异无统计学意义(P>0.05);治疗5 d时替格瑞洛组血小板抑制率高于氯吡格雷组(69.22±12.34)% vs (46.87±22.1)%(P<0.05),血小板抵抗率低于氯吡格雷组(2.53% vs 22.67%)(P<0.05)。结论:在行PCI治疗的STEMI合并DM患者中应用替格瑞洛可改善预后,且安全性好。

Effects of ticagrelor on patients with ST-segment elevation myocardial infarction and diabetes undergoing percutaneous coronary intervention

OBJECTIVE To evaluate effects and safety of ticagrelor on patients with ST-segment elevation myocardial infarction (STEMI) and diabetes mellitus (DM) undergoing percutaneous coronary intervention (PCI).METHODS A total of 154 patients with STEMI and DM were randomized into ticagrelor treated group (n=79) and clopidogrel group (n=75). After treatment, all cause mortality, major adverse cardiac events (MACE), stent thrombosis, LVEF, bleeding and dyspnea were compared between the two groups at different time points. After patients in the two groups took corresponding drugs for 5 days, platelet inhibition rate and resistant rate were determined by using thrombelastograph.RESULTS No significant difference was noted in all cause mortality, MACE or stent thrombosis between two groups (P>0.05). Ticagrelor significantly reduced stent restenosis (P<0.05). Ticagrelor group presented better effects on LVEF than clopidogrel group (P<0.05). Ticagrelor group showed higher rate of dyspnea (P<0.05) but similar rate of major bleeding events (P>0.05) compared with clopidogrel group. Ticagrelor significantly increased platelet inhibition rate of adenosine diphosphate pathways (69.22±12.34)% vs. (46.87±22.1)% and reduced resistant rate of platelets (2.53% vs. 22.67%).CONCLUSION Ticagrelor can significantly improve prognosis in patients with STEMI and DM undergoing PCI, without increase in major bleeding events.