摘要
【目的】探讨替格瑞洛对非ST段抬高型急性心肌梗死(non-ST-elevation myocardial infarction,NSTEMI)合并糖尿病(diabetes mellitus,DM)患者的心肌保护作用。【方法】选取2015年3月至2016年12月我院收治的NSTEMI合并DM患者120例,根据入院顺序分为对照组和观察组,各60例,两组患者均接受常规治疗,对照组患者在此基础上口服氯吡格雷,观察组患者在此基础上口服替格瑞洛,两组患者均连续治疗6个月,随访3个月。比较两组患者治疗前后的心肌损伤标志物:肌酸激酶同工酶(creatine kinase MB,CK-MB)、肌钙蛋白(troponin,cTnI)。心功能指标:舒张早期心室充盈速度最大值(E)/舒张晚期心室充盈速度最大值(A),左心室舒张末径(left ventricular end diastolic diameter,LVEDD)、左心室射血分数(left ventricular ejection fraction,LVEF),以及主要心血管不良事件(major adverse cardiovascular events,MACE)发生率和出血并发症发生率。【结果】治疗前两组患者CK-MB,cTnI比较,差异无统计学意义(P>0.05);治疗后观察组患者CK-MB,cTnI低于对照组(P<0.05);治疗后两组患者CK-MB、cTnI均低于治疗前(P<0.05)。治疗前两组患者E/A、LVEDD、LVEF比较,差异无统计学意义(P>0.05);治疗后观察组患者E/A、LVEF高于对照组,LVEDD低于对照组(P<0.05);治疗后两组患者E/A、LVEF均高于治疗前,LVEDD均低于治疗前(P<0.05)。观察组患者MACE发生率低于对照组(P<0.05);两组患者出血并发症发生率比较,差异无统计学意义(P>0.05)。【结论】替格瑞洛可有效减轻NTSE-ACS合并DM患者的心肌损伤,改善心功能,降低MACE发生率,且不增加出血风险。
【Objective】To explore the myocardial protective effect of ticagrelor in non-ST-elevation acute myocardial infarction（NTSEAMI） patients combined with diabetes mellitus（DM）.【Methods】A total of 120 NTSE-AMI patients combined with DM in our hospital were selected from March 2015 to December 2016.They were divided into the control group and observation group according to admission order,60 cases per group.Based on conventional treatment,patients in the control group were treated with oral clopidogrel,and those in the observation group were treated with oral ticagrelor.All the patients were treated for 6 months and followed up for 3 months.The myocardial injury markers were compared between the two groups,including creatine kinase isozyme（CK-MB） and troponin（cTnI）.Maximum heart function indexes were also analyzed,including early diastolic ventricular filling velocity（E）/late diastolic ventricular filling speed maximum（A）,left ventricular end-diastolic diameter（LVEDD）,left ventricular ejection fraction（LVEF） and the incidence of major adverse cardiovascular events（MACE） and bleeding complications.【Results】There was no statistically significant difference in CK-MB and cTnI before the treatment between the two groups（P〉0.05）.After the treatment,the levels of CK-MB and cTnI in the observation group were lower than those in the control group（P〈0.05）.In both groups,the levels of CK-MB and cTnI after the treatment were lower than those before the treatment（P〈0.05）.There was no statistically significant difference in E/A,LVEDD and LVEF before the treatment between the two groups（P〉0.05）.After the treatment,the levels of E/A and LVEF in the observation group were higher than those in the control group,and the level of LVEDD was lower than that in the control group（P0.05）.In both groups,the levels of E/A and LVEF after the treatment were higher than those before the treatment,and the level of LVEDD was lower than that before the treatment（P〈0.05）.T
出处
《武警后勤学院学报（医学版）》
CAS
2017年第10期854-857,共4页
Journal of Logistics University of PAP（Medical Sciences）
关键词
急性心肌梗死
替格瑞洛
糖尿病
氯吡格雷
心肌保护
Acute myocardial infarction
Ticagrelor
Diabetes
Clopidogrel
Myocardial protection
