摘要
目的 比较替格瑞洛与氯吡格雷在ST段抬高型心肌梗死（ST elevation myocardial infarction,STEMI）患者经皮冠状动脉介入（percutaneous coronary intervention,PCI）治疗中的应用效果。方法 选取2014年3月～2016年5月浙江省台州市第一人民医院收治的118例行PCI的急性ST段抬高型心肌梗死患者,按照随机数字表法将所有患者随机分为氯吡格雷组（A组）和替格瑞洛组（B组）,术前给予A组患者300 mg阿司匹林联合600 mg氯吡格雷进行治疗,B组术前给予300 mg阿司匹林联合180 g替格瑞洛进行治疗。比较2组患者的术中梗死相关动脉即刻心肌梗死溶栓试验3级血流和术后1.5 h ST段回落、术后1月心脏B超情况、呼吸困难发生率、不良心脏事件、出血事件等。结果 B组患者在术后1.5 h的ST段回落均值和ST段回落发生率均显著高于A组（t=12.234,χ^2=7.829,P〈0.05）。术后1月,B组患者的LVEF值显著高于A组（t=5.393,P〈0.05）;2组患者LVDD值比较差异无统计学意义。B组患者的呼吸困难发生率和即刻TIMI3级血流发生率分别为24.6%和88.5%,均显著高于A组患者的8.8%和68.4%（χ^2=4.293,χ^2=4.392,P〈0.05）。A组患者术后1月内不良心血管事件的发生率为19.3%,显著高于B组患者的4.9%（χ^2=2.193,P〈0.05）;2组患者出血事件发生率比较差异无统计学意义。结论 替格瑞洛治疗行PCI手术的STEMI患者效果显著,能够在不增加出血风险的情况下有效改善患者的心肌再灌注和预后,提高患者术中即刻心肌梗死溶栓试验3级血流的发生率。
Objective To comparison of the effect of tigrine and clopidogrel in PCI in patients with STEMI .Methods 118 cases of routine PCI in patients with acute ST segment elevation myocardial infarction from March 2014 to May 2014 in our hospital were select, according to random number table method to all of the patients were randomly divided into clopidogrel group （group A） and tigrine group（group B）, preoperative group A received 300 mg of aspirin combined with 600 mg of clopidogrel for treatment,group B received 300 mg aspirin combined with 180g of tigrolipine for preoperative treatment.Compared the two groups of patients with intraoperative infarct-related artery myocardial infarction thrombolytic test three blood flow and 1.5 hours after ST segment fall, postoperative heart B in the situation, the incidence of dyspnea, adverse cardiac events, bleeding events.Results The incidence of ST segment depression and the incidence of ST segment depression in group B were significantly higher than those in group A （t=12.234,χ^2 =7.829,P〈0.05）.One month after surgery, B group of patients with LVEF value was significantly higher than the A group （t=5.393,P〈0.05）;there was no significant difference in LVDD between the two groups.The incidence of dyspnea and immediate TIMI grade 3 blood flow in group B were 24.6% and 88.5%, respectively, which were significantly higher than those in group A and 8.8% and 68.4% （χ^2 =4.293,χ^2 =4.392,P〈0.05）. The incidence of adverse cardiovascular events was 19.3% in group A, which was significantly higher than that in group B （χ^2 =2.193,P〈0.05）. There was no significant difference in the incidence of bleeding between the two groups.Conclusion The use of STEMI patients underwent PCI surgery ticagrelor treatment, in case of the risk of bleeding can effectively improve the patient＇s myocardial reperfusion and prognosis does not increase , the increased incidence of immediate thrombolysis in myocardial infarction patients in the three grade .
出处
《中国生化药物杂志》
CAS
2017年第3期246-248,共3页
Chinese Journal of Biochemical Pharmaceutics
