中国临床药学杂志

目的 探究替格瑞洛联合阿司匹林对急性心肌梗死（AMI）患者疗效的影响。方法 选取2021年6月至2024年1月确诊的113例行经皮冠状动脉介入（PCI）的AMI患者为研究对象，随机分为对照组（n=57）和观察组（n=56），对照组术后采用氯吡格雷联合阿司匹林治疗，观察组术后采用替格瑞洛联合阿司匹林治疗。比较2组临床疗效、冠状动脉微循环情况、斑块稳定性、运动耐力、生活质量和不良反应发生情况。结果 治疗3个月后，观察组总有效率高于对照组（P<0.05），冠状动脉微循环情况优于对照组（P<0.05）;2组冠状动脉斑块大小、厚度及血管中膜厚度均较治疗前降低（P<0.05），并且观察组低于对照组（P<0.05）;2组运动耐力和生活质量均优于治疗前（P<0.05），并且观察组优于对照组（P<0.05）;2组恶心呕吐、消化道出血、皮疹和腹泻不良反应总发生率比较差异无统计学意义（P > 0.05）。结论 替格瑞洛联合阿司匹林对AMI患者的疗效优于氯吡格雷联合阿司匹林，能够明显改善AMI患者的冠状动脉微循环，提高冠状动脉斑块稳定性，改善运动耐力和生活质量，安全性良好，值得临床推广。

AIM To investigate the impacts of ticagrelor combined with aspirin on the efficacy in patients with acute myocardial infarction (AMI).METHODS A total of 113 AMI patients undergoing percutaneous coronary intervention (PCI) diagnosed in our hospital from June 2021 to January 2024 were taken as subjects.They were randomly assigned to the monitored group (n=56) and the control group (n=57).The control group was treated with aspirin combined with clopidogrel,while the monitored group was treated with aspirin combined with ticagrelor.Patients in2 groups were compared regarding efficacy,coronary microcirculation,plaque stability,exercise endurance,quality of life,and adverse reactions.RESULTS After 3 months of treatment,the total effective rate of the monitored group was greatly higher than that of the control group (P<0.05).Both groups were showed great improvement in coronary microcirculation,and the monitored group was greatly better than the control group (P<0.05).After treatment,the size,thickness,and intima-media thickness of coronary artery plaques were decreased in both groups,and the improvement in the monitored group was better than that in the control group (P<0.05).After treatment,the scores of exercise endurance and quality of life in both were groups greatly improved,and the monitored group had better scores than the control group(P<0.05).Total incidence of adverse reactions (such as nausea and vomiting,gastrointestinal bleeding,rash and diarrhea)was not statistically greatly different between 2 groups (P>0.05).CONCLUSION The combination of ticagrelor and aspirin has a great therapeutic effect on AMI patients,which can greatly improve coronary microcirculation,enhance plaque stability,improve exercise endurance and quality of life,with high safety and ideal efficacy,which is worthy of clinical application and promotion.