替格瑞洛联合急诊经皮冠脉介入术治疗急性心肌梗死的效果及安全性
Efficacy and safety of ticagrelor combined with emergency percutaneous coronary intervention in the treatment of acute myocardial infarction
吕莹 1严自强 1徐慧欣 1王晓伟2
作者信息
- 1. 海军军医大学附属长海医院药剂科,上海 200433
- 2. 海军军医大学附属长海医院心胸外科,上海 200433
- 折叠
摘要
目的 观察替格瑞洛联合急诊经皮冠脉介入术(PCI)治疗急性心肌梗死的效果及安全性.方法 选择2021年3月至2022年6月进行急诊PCI治疗的127例急性心肌梗死患者作为研究对象,随机分为对照组(63例)和试验组(64例).2组术前分别予氯吡格雷和替格瑞洛进行抗血小板治疗,比较2组治疗后心肌功能、血小板聚集功能、血流情况及出血不良事件发生情况.结果 试验组PCI术后10 min及术后24 h的肌酸激酶同工酶及心肌肌钙蛋白I水平低于对照组(P＜0.05),二磷酸腺苷(ADP)途径血小板抑制率高于对照组(P＜0.05),血小板最大聚集率和P2Y12反应单位低于对照组(P＜0.05).与对照组比较,试验组术后当天2组TIMI分级和TMP分级分布差异有统计学意义(P＜0.05).术后当天试验组左室射血分数高于对照组,左心室舒张末内径小于对照组(P＜0.05).2组治疗期间出血不良事件发生率比较差异无统计学意义(P＞0.05).结论 替格瑞洛联合急诊PCI治疗急性心肌梗死的效果优于氯吡格雷联合急诊PCI,能够有效改善患者围术期心肌损伤和血流灌注,提高心肌功能,且不增加出血不良事件的发生风险.
Abstract
AIM To observe the effect of ticagrelor combined with emergency percutaneous coronary intervention(PCI)in the treatment of acute myocardial infarction(AMI).METHODS A total of 127 patients with acute myocardial infarction who underwent emergency PCI treatment in our hospital from March 2021 to June 2022 were selected for experimental observation,and the patients were randomly divided into control group(63 patients)and experimental group(64 patients).The patients in the 2 groups received antiplatelet therapy with clopidogrel and ticagrelor respectively during the preoperative stage.The platelet aggregation function,myocardial function and blood flow after antiplatelet therapy and the occurrence of bleeding events were compared between 2 groups.RESULTS The levels of creatine kinase-MB(CK-MB)and cardiac troponin I(CTnI)at 10 min and 24 h after PCI in the experimental group were significantly lower than those in the control group(P＜0.05).The platelet inhibition index of the ADP pathway in the experimental group was significantly higher than that in the control group,and the maximum platelet aggregation index and P2Y12 response unit were significantly lower than those in the control group(P＜0.05).After treatment,the distribution in grade of thrombolysis in myocardial infarction(TIMI)and TIMI myocardial perfusion(TMP)on the day after operation between 2 groups was significantly confident(P＜0.05).The left ventricular ejection fraction in the experimental group was significantly higher than that in the control group,and the left ventricular end-diastolic diameter was significantly lower than that in the control group(P＜0.05).There was no significant difference in the incidence of bleeding events between 2 groups during treatment(P＞0.05).CONCLUSION The inhibitory effect of ticagrelor on platelet aggregation is significantly better than that of clopidogrel.Combined with emergency PCI in the treatment of acute myocardial infarction,ticagrelor can effectively improve the degree of perioperative myocardial injury,improve myocardial blood perfusion,enhance cardiac systolic function,and dose not increase the risk of adverse events.
关键词
替格瑞洛/急诊经皮冠脉介入术/急性心肌梗死/血浆心肌损伤因子Key words
ticagrelor/emergency percutaneous coronary intervention/acute myocardial infarction/plasma myocardial injury factor引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
万方数据