摘要
目的:探究替格瑞洛与氯吡格雷对ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)术后超声心动图指标、炎症反应及心血管不良事件的影响。方法:选取2016年1月~2018年2月本院行PCI治疗的704例STEMI患者为研究对象,分为研究组(n=352)和对照组(n=352)。其中,研究组术后服用替格瑞洛,对照组术后服用氯吡格雷。比较两组服药前后超声心动图指标、炎症反应及心血管不良事件的差异。结果:治疗后研究组的左室射血分数(LVEF)大于对照组(P<0.05),左室舒张末期内径(LVEDD)、左室舒张末容积指数(LVEDVI)、二尖瓣血流频谱E/A比值低于对照组(P<0.05)。两组IL-6、IL-8、高敏C反应蛋白(hs-CRP)水平均降低(P<0.05),研究组IL-6、IL-8和hs-CRP水平低于对照组(P<0.05)。两组术后均有再发心肌梗死、心绞痛、心力衰竭、严重心律失常等心血管病症发生,但研究组的总发生率(5.97%)显著低于对照组(22.73%)(χ^2=40.238,P<0.05)。术后两组不良反应发生情况无统计学差异。结论:替格瑞洛与氯吡格雷均可有效促进STEMI术后患者心功能恢复,改善炎症反应,降低心血管不良事件发生率,但替格瑞洛治疗优势相对于氯吡格雷更加明显。
Objective:To investigate the effects of tigrel and clopidogrel on echocardiographic indicators,inflammatory responses and adverse cardiovascular events after percutaneous coronary intervention(PCI)in patients with ST-segment elevation myocardial infarction(STEMI).Methods:A total of 704 STEMI patients who underwent PCI in our hospital from January 2016 to February 2018 were selected as study subjects,divided into a study group(n=352)and a control group(n=352).The study group was given tigrel after surgery,while the control group was given clopidogrel after surgery.The differences in echocardiographic parameters,inflammatory responses and adverse cardiovascular events before and after administration were compared between the two groups.Results:After treatment,the left ventricular ejection fraction(LVEF)of the study group was larger than that of the control group(P<0.05),while the left ventricular end-diastolic diameter(LVEDD),left ventricular end-diastolic volume index(LVEDVI)and the mitral valve flow spectrum E/A ratio were lower than that of the control group(P<0.05).The levels of IL-6,IL-8 and hs-CRP in both groups were decreased(P<0.05),and the levels of IL-6,IL-8 and hs-CRP in the study group were lower than those in the control group(P<0.05).Recurrent myocardial infarction,angina pectoris,heart failure,severe arrhythmia and other cardiovascular events occurred in both groups,but the overall incidence in the study group(5.97%)was significantly lower than that in the control group(22.73%)(χ^2=40.238,P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion:Both tigrel and clopidogrel can effectively promote the recovery of cardiac function,improve inflammatory response and reduce the incidence of adverse cardiovascular events after STEMI,but the advantages of tigrel are more obvious than clopidogrel.
作者
霍刘彬
郑腾飞
金晶晶
刘畅
HUO Liu-bin;ZHENG Teng-fei;JIN Jing-jing;LIU Chang(Department of Emergency Medicine,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450007,China;Department of Cardiac Rehabilitation,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450007,China)
出处
《中国合理用药探索》
CAS
2020年第1期57-60,共4页
Chinese Journal of Rational Drug Use
关键词
ST段抬高型心肌梗死
替格瑞洛
氯吡格雷
炎症反应
心血管不良事件
ST-segment elevation myocardial infarction
tigrel
clopidogrel
inflammatory response
adverse cardiovascular events
