| 摘要: |
| 抗血小板治疗是冠心病患者治疗的基石，目前在PCI术后常规给予阿司匹林与氯吡格雷双重抗血小板治疗，但由于基因多态性等原因，部分患者存在氯吡格雷抵抗使抗血小板效果不佳。而替格瑞洛是抗血小板的新药，与既往的P2Y12受体拮抗剂不同，其较好的口服吸收率、生物利用度、无需经肝酶代谢激活等特性显示了较好的抑制血小板聚集效果。经过大规模临床研究证明了替格瑞洛在治疗急性冠脉综合征患者优于氯吡格雷。但由于其在国内使用时间尚短，对于存在的副作用如呼吸困难的发生机制以及处理经验尚欠缺。因此本文报道了10例服药后呼吸困难患者，并检索文献，明确了PCI术后服用替格瑞洛发生呼吸困难的相对危险度是服用氯吡格雷的1.93倍，并探讨了替格瑞洛服用后呼吸困难的发生机制。 |
| 关键词: 替格瑞洛 氯吡格雷 呼吸困难 冠心病 |
| DOI：10.3724/SP.J.1008.2015.00348 |
| 投稿时间：2014-11-10修订日期：2014-12-03 |
| 基金项目:国家自然科学基金 (81370266),上海市科委基金 (134119a0301). |
|
| Dyspnea caused by ticagrelor therapy: a case report |
| FENG Can1,GUO Jun1,JI Tao2,ZHU Jia-qi1,ZHAO Xian-xian1* |
(1. Department of Cardiology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China;
2. Department of Geriatrics, Shanghai First People's Hospital, Shanghai Jiaotong University, Shanghai 200080, China
*Corresponding author) |
| Abstract: |
| Antiplatelet therapy is the cornerstone of treatment in patients with coronary heart disease . Currently its medical routine for patients who received PCI take dual antiplatelet therapy of aspirin and clopidogrel. Due to genetic polymorphism and other reasons, some patients appeared clopidogrel resistance leading to poor antiplatelet effect. Ticagrelor is a new antiplatelet drug different from past P2Y12 receptor antagonis, its better oral absorption rate and bioavailability, without metabolic activation by liver enzymes showed good characteristics to inhibit platelet aggregation. Large-scale clinical studies have shown tha ticagrelor was superior to clopidogrel in patients with acute coronary syndrome. Because of its short time usage in China, the mechanism for the occurrence of dyspnea was not widely known. And the dealing experience to dyspnea is still lacking. Therefore, this paper reported 10 cases of patients with dyspnea after treatment of ticagrelor, retrieved literature finding the odds ratio for ticagrelor was 1.93 times compared with clopidogrel, and discussed the mechanism of dyspnea. |
| Key words: ticagrelor clopidogrel dyspnea coronary disease |
