目的 比较替格瑞洛和氯吡格雷对行经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗的急性冠脉综合征(acute coronary Syndrome,ACS)的疗效.方法 选择2014-06至2015-06医院收取的68例采用PCI治疗的ACS患者,随机分为替格瑞洛组和氯吡格雷组.用药7 d后,复查血栓弹力图(TEG)比较两组血小板抑制率,随访2个月,对比两组的主要不良事件.结果 服药7 d后,替格瑞洛组ADP途径血小板抑制率较氯吡格雷组升高[(76.15 ±12.88)％ vs(51.08 ± 8.32)％],差异有统计学意义(P ＜0.01).经2个月随访,氯吡格雷组出现急性心肌梗死、心血管死亡、消化道出血各1例,替格瑞洛组1例因明显呼吸困难导致停药.结论在接受PCI的ACS患者中,替格瑞洛抗血小板聚集效果较氯吡格雷更强,且临床验证安全.%Objective To investigate the therapeutic effect of ticagrelor and clopidogrel in patients with acute coronary syndrome (ACS). Methods Sixty-eight patients with ACS who were admitted to our department were enrolled in this study. All the patients were treated with percutaneous coronary intervention (PCI) before they were randomly divided into two groups: ticagrelor group and clopidogrel group(n =34 in each). After seven days, thrombelastography (TEG ) was used to compare the platelet inhibition rate between the two groups. After two months of follow-up, the major adverse events were compared between the two groups. Results After seven days of treatment, the platelet inhibition rate induced by ADP in ticagrelor group increased significantly (76.15±12.88)％ vs(51.08 ± 8.32) ％ compared with clopidogrel group. After two months of follow-up,there was one case of acute myocardial infarction, one death due to cardiovascular diseases and one case of gastrointestinal bleeding in clopidogrel group. One patient in ticagrelor group had medication suspended because of serious dyspnea. Conclusions For ACS patients who have received PCI, ticagrelor has a better anti platelet aggregation effect than clopidogrel, and it has proved to be safe.
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