替格瑞洛和氯吡格雷改善急性冠状动脉综合征冠状动脉微血管功能障碍临床研究

摘要

目的:评价替格瑞洛和氯吡格雷改善急性冠状动脉综合征(ACS)患者经皮冠状动脉介入术(PCI)术后冠状动脉微血管功能障碍的临床疗效.方法:选择2014年1月至2016年6月,接受PCI手术的ACS患者45例,随机分为替格瑞洛组22例和氯吡格雷组23例,分别在PCI术前12h内给予替格瑞洛片180mg和氯吡格雷片600mg口服,采用术前和术后微循环阻力指数(IMR)、血流储备分数(EFR)和冠状动脉血流储备(CFR)进行微循环功能评价.结果:45例患者均顺利完成手术,PCI术前两组FFR、IMR和CFR组间比较差异无统计学意义(P＞0.05);以疗前数值为协变量,替格瑞洛组疗后IMR、CFR优于氯吡格雷组(P＜0.05),而FFR组间比较无明显差异(P＞0.05).结论:PCI术前口服替格瑞洛改善冠状动脉微循环功能障碍的效果优于氯吡格雷.%Objective:To evaluate the efficacy of ticagrelor and clopidogrel for coronary microvascular dysfunction improving after percutaneous coronary intervention (PCI) in acute coronary syndromes (ACS).Methods:From January 2014 to June 2016,45 patients with ACS undergoing PCI were randomly divided into tigrielol group (n =22) and clopidogrel group (n =23).Before and after PCI,180 mg of tegrelloxil tablets and 600 mg of clopidogrel tablets were administrated orally.Index of microcirculatory resistance (IMR),flow re.serve fraction (FFR) and coronary flow reserve (CFR) were evaluated for microvascular.Results:45 patients completed the operation successfully.Before treatment,there were no significant differences in FFR,IMR and CFR between the two groups (P ＞ 0.05).IMR,CFR was superior to clopidogrel group (P ＜ 0.05),but there was no significant difference in FFR between two groups (P ＞ 0.05).Conclusion:The effect of ticagrelor for coronary microcirculation dysfunction improvement is better than that clopidogrel.