摘要
目的探讨急性心肌梗死(AMI)患者经皮冠状动脉介入术(PCI)前使用替格瑞洛的治疗价值及对患者血清炎症因子的影响。方法选取本院2013年5月~2015年12月实施PCI治疗的AMI患者120例,随机分为替格瑞洛组和氯吡格雷组两组,每组各60例。两组患者入院后均给予开通静脉通道,降压、补液、纠正电解质紊乱等对症治疗,氯吡格雷组采用阿司匹林和氯吡格雷口服;替格瑞洛组口服阿司匹林的同时,联合采用替格瑞洛。检测并对比两组患者用药前、用药72 h后、用药1周后的血小板聚集率,血清炎症因子:C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、可溶性CD40配体(sCD40L)。对比两组患者PCI手术前、后的TIMI血流分级分布变化及TIMI帧数。数据统计分析采用SAS 10.0进行处理。结果替格瑞洛组患者术后72 h、术后1周的血小板聚集率均低于氯吡格雷组,差异具有统计学意义(P<0.05);术前两组患者的血清CRP、IL-6、TNF-α、sCD40L水平差异均无统计学意义(P>0.05);术后72 h、术后1周,替格瑞洛组血清CRP、IL-6、TNF-α、sCD40L水平均低于氯吡格雷组,差异具有统计学意义(P<0.05);术前两组患者TIMI血流分级差异均无统计学意义(P>0.05);术后,替格瑞洛组TIMI血流分级优于氯吡格雷组,差异具有统计学意义(P<0.05)。结论AMI患者PCI术前使用替格瑞洛能够更好的改善患者心肌再灌注水平、降低血清炎症因子、且安全性较好。
Objective To investigate the therapeutic value of ticagrelor and its influence on serum inflammatory factors in patients with acute myocardial infarction(AMI)before percutaneous coronary intervention(PCI).Methods AMI patients(n=120)received PCI were chosen from Shanghai Changhai Hospital from May 2013 to Dec.2015,and randomly divided into ticagrelor group and clopidogrel group(each n=60).The symptomatic treatment,including opening venous access,down-regulating blood pressure,fluid supplement and correcting electrolyte disturbance,were given to 2 groups after admission.Clopidogrel group was orally given aspirin and clopidogrel,and ticagrelor group was orally given aspirin and clopidogrel.The indexes of platelet aggregation rate(PAG)and serum inflammatory factors,including C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and soluble CD40 ligand(sCD40L),were detected and compared in 2 groups before and 72 h and 1 week after drug treatment.The changes of TIMI flow grades and TIMI frame count(TFC)were compared between 2 groups before and after PCI.The statistic analysis on data was conducted by using SAS 10.0 software.Results PAG was lower in ticagrelor group than that in clopidogrel group 72 h and 1 week after PCI(P<0.05).The difference in levels of serum CRP,IL-6,TNF-αand sCD40L had no statistical significance between 2 groups before PCI(P>0.05).The levels of serum CRP,IL-6,TNF-αand sCD40L were lower in ticagrelor group than those in clopidogrel group 72 h and 1 week after PCI(P<0.05).The difference in TIMI flow grades had no statistical significance between 2 groups before PCI(P>0.05),and TIMI flow grades were better in ticagrelor group than those in clopidogrel group after PCI(P<0.05).Conclusion Ticagrelor,administrated before PCI,will improve myocardial reperfusion level and reduce serum inflammatory factors with higher safety in AMI patients before PCI.
作者
刘月娥
那剑
王美堂
Liu Yue’e;Na Jian;Wang Meitang(Emergency Department,Shanghai Changhai Hospital,Shanghai 2000433,China)
出处
《中国循证心血管医学杂志》
2018年第8期967-969,共3页
Chinese Journal of Evidence-Based Cardiovascular Medicine
关键词
急性心肌梗死
经皮冠状动脉介入术
替格瑞洛
炎症因子
Acute myocardial infarction
Percutaneous coronary intervention
Ticagrelor
Inflammatory factors
