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目的：评价替格瑞洛在氯吡格雷抵抗的急性STEMI患者的抗血小板治疗的有效性及安全性。方法入选郑州市心血管病医院2013年11月-2014年10月期间STEMI患者97例，氯吡格雷负荷量口服24 h后，血小板抑制率30%正常对照组。两组出院2周后复查ADP抑制率，观察1个月内主要心脏不良事件（MACE）、严重出血及血栓事件发生率。结果入院后替格瑞洛组经TEG检测ADP诱导的血小板聚集抑制率为（24.5±5.1）%，正常对照组ADP诱导的血小板聚集抑制率为（52.5±7.1）%。出院2周门诊复查，替格瑞洛组ADP诱导的血小板聚集抑制率为（57.3±11.7）%，与入院后比较其差异具有统计学意义（P<0.05）。出院1月内，两组均未发生MACE、严重出血及血栓事件。结论替格瑞洛能够有效提高氯吡格雷抵抗的急性STEMI患者中ADP诱导的血小板聚合抑制率，不增加大出血，MACE发生率低。“,”Objective To investigate the clinical efficacy and safety of Tigraylo in acute ST–elevation myocardial infarction(STE-MI) patient with clopidogrel resistance. Methods Randomly selected 97 STEMI patients of our hospital from 2013.11to 2014.10.All patients took clopidogrel (600mg load) .The patients were divided into two group based on the thromboelastography-determined platelet inhibition rate within 24 hours after taking clopidogrel. The Tigraylo group, defined by platelet inhibition rate 30%, included 60 cases. The platelet inhibition rate was check after 2 weeks. The incidence of major adverse cardiovascular events (MACE) and hemorrhagic events of the two group were compared after 30 days. Results After treatment with Tigraylo, the Tigraylo group had platelet inhibition rate returned to normal, and significant difference with use clopidogrel. The differences of MACE and hemorrhage rate during 30 days between two groups were not statistically significant. Conclusion Compared to clopidogrel, Tigraylo can significant reduce the incidence of cardiovas-cular events in STEMI patients without increasing bleeding,can also decrease MACE and prevent the acute thrombosis in patients with clopidogrel resistant.