冠心病二级预防的抗血小板治疗分析

周慧龙

（洛川县菩堤乡卫生院，陕西 延安，727401）

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摘要：

目的 针对冠心病二级预防的抗血小板治疗展开讨论，为日后的临床治疗提供参考与指导。方法 选择我院2013年2月至2015年9月收治的冠心病患者200例，应用随机数字表法将其分为四组，每组50例。四组患者分别给予阿司匹林、氢 氯吡格雷、普拉格雷、替格瑞洛治疗，按照药物来确定组别名称。对4种药物的临床疗效进行观察，并且分析药物的优势、劣势。结果 阿司匹林组患者血小板抑制起效时间为40 min，长于氢氯吡格雷组、普拉格雷组及替格瑞洛组的30 min（P<0.05）。
在血小板抑制率方面，阿司匹林组为5.7%，氢氯吡格雷组为5.8%，普拉格雷组为31.0%，替格瑞洛组为41.0%，阿司匹林组与氢氯吡格雷组比较差异不显著（P>0.05）；替格瑞洛组高于普拉格雷组（P<0.05），高于其他两组患者（P<0.05）；在适应证对 比方面，阿司匹林与氢氯吡格雷相同，普拉格雷相对特殊，替格瑞洛最少，仅为ACS患者；在禁忌证方面，4种药物的禁忌证大部分相同，以替格瑞洛禁忌证最多。结论 冠心病二级预防的抗血小板治疗过程中，临床应用药物种类较多，以阿司匹林、氢氯吡格雷、普拉格雷、替格瑞洛为主，每种药物都有自己的特点，临床治疗过程中，应根据患者的个体情况，合理选择药物治疗，高度关注适应证和禁忌证，减少对患者造成的不良影响。

关键词：冠心病；二级预防；抗血小板聚集

中图分类号：R541.4文献标志码：A文章编号：2096-1413(2016)26-0072-02

Analysis of anti-platelet therapy in secondary prevention of coronary artery disease
ZHOU Hui-long
(Puti County Health Center, Yan`an 727401, China)

ABSTRACT: Objective To discuss the anti-platelet therapy in secondary prevention of coronary artery disease in order to provide reference and guidance for clinical treatment. Methods Two hundred patients in our hospital from February 2013 to September 2015 were selected and randomly divided into 4 groups, with 50 cases in each group. The people in 4 groups were respectively treated with aspirin, clopidogrel, prasugrel and ticagrelor, the 4 groups were named after the drug name. The clinical curative effect and the advantages and disadvantages of the 4 drug were compared. Results The inhibitory time of blood platelet aggregation in the aspirin group was 40 min, which was longer than 30 min in the clopidogrel group, prasugrel group and ticagrelor group (P<0.05). The inhibitory rate of blood platelet aggregation, in the aspirin group was 5.7% , in the clopidogrel group was 5.8% , in the prasugrel group was 31.0% , in the ticagrelor group was 41.0% . The difference between the aspirin group and the clopidogrel group was not significant (P>0.05). The inhibitory rate of blood platelet aggregation in the ticagrelor group was higher than that of prasugrel group and other two groups (P <0.05). In contrast of indications, aspirin was the same as clopidogrel, the prasugrel was relatively special, and the ticagrelor had least indications, only ACS patients. In terms of contraindications, 4 drugs were substantially the same drug contraindications, the ticagrelor had the most. Conclusion In the process of anti-platelet therapy in secondary prevention of coronary artery disease, there are many kinds of drugs in clinical application, the aspirin, clopidogrel, prasugrel and ticagrelor are the main drugs, each drug has its own characteristics. We should choose the reasonable drugs on the basis of the individual situation during the treatment. We also need to pay more attention to the indications and contraindications and to reduce the adverse impact on patients.
KEYWORDS: coronary artery disease; the secoronary prevention; anti-platelet aggregation

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