半量替格瑞洛对高龄急性冠脉综合征并发慢性肾功能不全患者的疗效和安全性

被引：11

作者：

张亮 ^{[1
]}

袁铭 ^{[1
]}

曹丰 ^{[2
]}

机构：

[1] 第四军医大学西京医院心血管内科

[2] 解放军总医院心内科

来源：

心脏杂志 | 2017年 / 29卷 / 03期

关键词：

替格瑞洛; 剂量; 高龄; 急性冠脉综合征; 慢性肾功能不全;

D O I：

10.13191/j.chj.2017.0077

中图分类号：

R541.4 [冠状动脉（粥样）硬化性心脏病（冠心病）]; R692 [肾疾病];

学科分类号：

100201 [内科学]; 100221 [泌尿外科学];

摘要：

目的探讨半剂量替格瑞洛在高龄(>75岁)冠脉综合征(ACS)并发肾功能不全(CRI)患者中的远期疗效及安全性。方法入选ACS并发CRI的患者93例,分为替格瑞洛全剂量组(n=48例)及半剂量组(n=45)。全剂量组替格瑞洛负荷剂量180 mg,随之90 mg,2次/d,半剂量组负荷剂量90 mg,随之45 mg,2次/d。进行记录及临床随访12个月,比较两组患者主要不良心脑血管事件(MACCE))的发生率,出血事件的发生率,及其他不良反应的发生率。结果两组患者在基线临床资料如年龄、性别、吸烟史、高脂血症、高血压病、肝功能、左室射血分数(LVEF)及肾小球滤过率估计值(e GFR)等均无显著差异,而糖尿病患病率及ST抬高型ACS(STEACS)的发生率在两组之间有显著差异(P<0.05)。随访12个月发现,全剂量组和半剂量组的MACCE事件分别发生9例(19%)和6例(13%),两组之间差异无统计学意义。全剂量组和半剂量组出血事件分别发生16例(33%)和6例(13%),均为轻度出血,半剂量组出血事件显著少于全剂量组,有显著性统计学差异(P<0.05),无严重或者致死性出血的发生。呼吸困难在全剂量组和半剂量组的发生率分别为12例(25%)和9例(20%),呼吸困难均是轻度、可耐受、一过性的,两组之间无显著性统计学差异。结论半剂量的替格瑞洛对于高龄(>75岁)ACS并发CRI患者中和全剂量替格瑞洛有同样的疗效,并且有较好的安全性。

引用

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页数：4

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