首页|经皮冠脉介入术前不同剂量的替格瑞洛治疗老年ST段抬高心肌梗死患者的效果及安全性

经皮冠脉介入术前不同剂量的替格瑞洛治疗老年ST段抬高心肌梗死患者的效果及安全性

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目的 探讨不同剂量的替格瑞洛对经皮冠脉介入术(PCI)老年ST段抬高心肌梗死(STEMI)患者的疗效及安全性.方法 选取 2018 年 7 月至 2021 年 6 月安徽省天长市中医院收治的 78 例拟行PCI治疗老年STEMI患者,采用随机数字表法分为对照组(术前给予阿司匹林 300 mg+替格瑞洛 90 mg)和观察组(术前给予阿司匹林300 mg+替格瑞洛 180 mg),每组各 39例.治疗前后比较两组血小板参数、心肌酶谱指标及冠状动脉血流情况.比较两组住院期间主要不良心脑血管事件发生情况.结果 治疗前两组血小板计数、血小板压积(PCT)及平均血小板体积(MPV)比较,差异均无统计学意义(P>0.05);治疗后两组血小板计数低于治疗前,PCT、MPV高于治疗前,且观察组血小板计数低于对照组,PCT、MPV高于对照组,差异有统计学意义(P<0.05).治疗前两组肌红蛋白(MB)、乳酸脱氢酶(LDH)、α-羟丁酸脱氢酶(HBDH)及心肌肌钙蛋白I(cTnI)比较,差异均无统计学意义(P>0.05);治疗后两组MB、LDH、HBDH及cTnI均低于治疗前,且观察组低于对照组(P<0.05).治疗前两组患者冠状动脉血流储备(CFVR)、左前降支收缩期血流峰值流速(SPV)及左前降支舒张期血流峰值流速(DPV)比较,差异均无统计学意义(P>0.05);治疗后两组CFVR、SPV及DPV均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05).两组住院期间主要不良心脑血管事件总发生率比较,差异无统计学意义(P>0.05).结论 老年STEMI患者PCI治疗前接受负荷剂量替格瑞洛治疗效果较好.
Efficacy and safety of preoperative Ticagrelor at different doses before percutaneous coronary intervention in elderly patients with ST segment elevation myocardial infarction
Objective To investigate the efficacy and safety of different doses of Ticagrelor before percutaneous coronary intervention(PCI)in the treatment of elderly patients with ST segment elevation myocardial infarction(STEMI).Methods A total of 78 elderly patients with STEMI admitted to Tianchang Hospital of Traditional Chinese Medicine of Anhui Province from July 2018 to June 2021 were selected and divided into control group(Aspirin 300 mg + Ticagrelor 90 mg preoperatively)and observation group(Aspirin 300 mg+ Ticagrelor 180 mg preoperatively)by random number table method,with 39 cases in each group.The platelet parameters,myocardial enzyme spectrum indexes,and coronary blood flow were compared between the two groups before and after treatment.The incidence of major adverse cardiovascular and cerebrovascular events during hospitalization were compared between the two groups.Results Before treatment,there were no significant differences in platelet count,plateletcrit(PCT),and mean platelet volume(MPV)between the two groups(P>0.05);after treatment,the platelet count in the two groups was lower than that before treatment,the PCT and MPV were higher than those before treatment,and platelet count in the observation group was lower than that in the control group,the PCT and MPV were higher than those in the control group,and the differences were statistically significant(P<0.05).Before treatment,there were no significant differences in myoglobin(MB),lactate dehydrogenase(LDH),alpha-hydroxy acid dehydrogenase(HBDH),and cardiac troponin I(cTnI)between the two groups(P>0.05);after treatment,MB,LDH,HBDH,and cTnI in the two groups were lower than those before treatment,and those in the observation group were lower than the control group,and the differences were statistically significant(P<0.05).Before treatment,there were no significant differences in coronary flow velocity reserve(CFVR),left anterior descending systolic peak velocity(SPV),and diastolic peak velocity(DPV)of left anterior descending artery between the two groups(P>0.05);after treatment,the CFVR,SPV,and DPV in the two groups were higher than those before treatment,and those of the observation group were higher than the control group,and the differences were statistically significant(P<0.05).There were no significant differences in the total incidence of major adverse cardiovascular and cerebrovascular events between the two groups during hospitalization(P>0.05).Conclusion Elderly STEMI patients who received loading dose of Ticagrelor before PCI has better effect.

ElderlyST segment elevation myocardial infarctionPercutaneous coronary interventionTicagrelor

洪守祥、岳正山、戴雪梅

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安徽省天长市中医院内一科,安徽天长 239300

老年 ST段抬高心肌梗死 经皮冠脉介入术 替格瑞洛

安徽省科技攻关计划

1804h08020246

2024

中国医药导报
中国医学科学院

中国医药导报

CSTPCD
影响因子:1.759
ISSN:1673-7210
年,卷(期):2024.21(8)
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