摘要
目的比较替格瑞洛与氯吡格雷在急性ST段抬高型心肌梗死患者急诊经皮冠状动脉介入治疗(PCI)中的应用效果。方法选取2015年8月—2017年2月上海市杨浦区市东医院收治的急性ST段抬高型心肌梗死患者114例,采用随机数字表法分为对照组和研究组,每组57例。在常规治疗基础上,对照组患者于急诊PCI术前及术后给予阿司匹林联合氯吡格雷治疗,而研究组患者于急诊PCI术前及术后给予阿司匹林联合替格瑞洛治疗。比较两组患者术后心肌梗死溶栓试验(TIMI)分级,术前及术后2 h、24 h、3 d、7 d血小板聚集率,术前及术后24 h、3 d、7 d、30 d血浆C反应蛋白(CRP)水平,并记录两组患者术后30 d内主要不良心血管事件(MACE)和出血事件发生情况。结果研究组患者术后TIMI分级优于对照组(P<0.05)。术前及术后7 d两组患者血小板聚集率比较,差异无统计学意义(P>0.05);术后2 h、24 h、3 d研究组患者血小板聚集率低于对照组(P<0.05)。术前及术后30 d两组患者血浆CRP水平比较,差异无统计学意义(P>0.05);术后24 h、3 d和7 d研究组患者血浆CRP水平低于对照组(P<0.05)。术后30 d内两组患者MACE、出血事件发生率比较,差异无统计学意义(P>0.05)。结论与氯吡格雷相比,替格瑞洛能更有效地改善急性ST段抬高型心肌梗死患者急诊PCI后TIMI分级,降低血浆CRP水平,且起效时间更快,安全性较高。
Objective To compare the application effect on emergency PCI in patients with acute ST-segment elevation myocardial infarction（ASTEMI） between ticagrelor and clopidogrel. Methods From August 2015 to February 2017, a total of 114 patients with ASTEMI were selected in East City Hospital of Yangpu District, Shanghai, and they were divided into control group and study group according to random number table, each of 57 cases. Based on conventional treatment, patients in control group received aspirin combined with clopidogrel before and after PCI, while patients in study group received aspirin combined with ticagrelor. TIMI grade after PCI, platelet aggregation rate before PCI, 2 hours, 24 hours, 3 days and 7 days after PCI, plasma CRP level before PCI, 24 hours, 3 days, 7 days and 30 days after PCI, incidence of MACE and bleeding events within 30 days after PCI were compared between the two groups. Results TIMI grade in study group was statistically significantly better than that in control group after PCI（P〈0.05）. No statistically significant differences of platelet aggregation rate was found between the two groups before PCI or 7 days after PCI（P〉0.05）, while platelet aggregation rate in study group was statistically significantly lower than that in control group 2 hours, 24 hours and 3 days after PCI,respectively（P〈0.05）. No statistically significant differences of plasma CRP level was found between the two groups before PCI or 30 days after PCI（P〉0.05）, while plasma CRP level in study group was study group was statistically significantly lower than that in control group 24 hours, 3 days and 7 days after PCI, respectively（P〈0.05）. No statistically significant differences of incidence of MACE or bleeding events was found between the two groups within 30 days after PCI（P〉0.05）. Conclusion Compared with clopidogrel, ticagrelor can more effectively improve the TIMI grade and reduce the plasma CRP level in ASTEMI patients undergoing emergency PCI, with faster onset time and relat
作者
冯六六
刘天华
史骏
刘新兵
单蓉
白艳艳
FENG Liu-liu;LIU Tian-hua;SHI Jun;LIU Xin-bing;SHAN Rong;BAI Yan-yan(Department of Cardiology, East City Hospital of Yangpu District, Shanghai, Shanghai 200438, Chin)
出处
《实用心脑肺血管病杂志》
2018年第3期54-57,共4页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
基金
上海市卫生和计划生育委员会科研课题项目(201540298)
