摘要
目的：观察行急诊经皮冠状动脉介入（PCI）术前给予替格瑞洛对急性ST段抬高型心肌梗死（STEMI）患者心肌组织灌注及疗效的影响。方法：90例成功行急诊PCI治疗的STEMI患者,随机均分为观察组和对照组;行PCI术前,观察组给予负荷剂量的替格瑞洛（180 mg）,对照组给予负荷剂量的氯吡格雷（600 mg）;术后即刻采用心肌梗死溶栓治疗（TIMI）血流分级和术后2 h ST段回落程度（STR）评估患者术后心肌组织灌注水平,比较患者PCI术后1周和1月时的左室射血分数（LVEF）、左室舒张末径（LVEDD）、心源性死亡、再次发生心肌梗塞及再次血运重建心脏主要不良事件的发生率。结果：与术前比较,2组患者术后TIMI血流0~2级患者比例降低（P〈0.05）,观察组降低更明显（P〈0.05）;观察组术后2 h STR良好的患者比例高于对照组（P〈0.05）;两组患者术后1月LVEF较术后1周明显升高,LVEDD明显降低（P〈0.05）,但同时点两组比较,差异无统计学意义（P〉0.05）;术后心源性死亡、再次发生心肌梗塞及再次血运重建发生率比较,差异无统计学意义（P〉0.05）。结论：STEMI患者行PCI术前给予替格瑞洛的可改善患者术后心脏功能。
Objective： To observe the influence and efficacy of Ticagrelor treatment on the perfusion of myocardial tissue before emergent percutaneous coronary intervention（ PCI） on patients with acute ST elevation myocardial infarction（ STEMI）. Methods： 90 patients with STEMI successfully performed emergent PCI were divided randomly into two groups,observation group and control group with equal number. Observation group was given 180 mg volume of Ticagrelor; control group was given600 mg volume of Clopidogrel. Immediate application of TIMI myocardial infarction reperfusion and 2 h postoperative ST-segment resolution（ 50%） were adopted to evaluate the perfusion level of myocardial tissue after PCI. Comparing LVEF,LVEDD,the incidence rates of cardiac function and MACE at 1week and 1 month after operation. Results： Comparing with before operation condition,proportion of both groups patients with TIMI flow grades of 0 to 2 has reduced（ P〈0. 05）,observation group has reduced significantly（ P〈0. 05）; proportion of 2 h postoperative ST-segment patients was higher than that of control group（ P〈0. 05）. LVEF of both groups has improved significantly 1 week after operation,LVEDD has reduced significantly（ P〈0. 05）; meanwhile,the difference of same time points comparison of both groups showed no statistical significance（ P〈0. 05）. The incidence rates of cardiac function and major adverse cardiovascular events（ MACE） comparison showed no statistical difference（ P〈0. 05）. Conclusion： The STEMI patients given Ticagrelor before PCI were proved to improve postoperative cardio function.
出处
《贵阳医学院学报》
CAS
2016年第5期584-586,593,共4页
Journal of Guiyang Medical College
基金
贵州医科大学附院博士基金[gY Fybj(2016)01]
