摘要
目的分析冠心病介入治疗(PCI)后应用不同剂量替格瑞洛对血小板反应的影响。方法选择2019年2月至2021年5月收治的128例PCI患者为研究对象,以随机数字表法将其分为对照组和观察组,每组64例。PCI后,对照组接受大剂量替格瑞洛治疗,观察组接受小剂量替格瑞洛治疗。比较两组的治疗效果。结果治疗前、后,两组的花生四稀酸诱导的血小板最大聚集率(AA-MAR)、二磷酸腺苷诱导的血小板最大聚集率(ADP-MAR)及血小板聚集率(PAR)无明显差异(P>0.05);治疗后,两组的AA-MAR、ADP-MAR及PAR均低于治疗前(P<0.05)。随访1年,观察组的出血事件总发生率为4.69%,低于对照组的15.63%(P<0.05)。治疗前、后,两组的冠状动脉血流速度储备(CFVR)、舒张期血流峰值(DPV)、收缩期血流峰值(SPV)及舒张期时间速度积分(CTVI)无明显差异(P>0.05);治疗后,两组的CFVR、DPV、SPV及CTVI高于治疗前(P<0.05)。治疗后,两组的心肌梗死溶栓临床试验心肌灌注分级(TMPG)分级中Ⅰ级占比低于治疗前,Ⅱ、Ⅲ级占比均高于治疗前(P<0.05)。结论PCI后使用替格瑞洛可抑制血小板聚集,改善冠脉血流及心肌灌注状况,且以小剂量进行治疗还能降低出血事件发生率。
Objective To analyze the effect of different doses of ticagrelor on platelet response after percutaneous coronary intervention(PCI).Methods A total of 128 patients with PCI admitted from February 2019 to May 2021 were selected as the research objects and divided into control group and observation group by random number table method,with 64 cases in each group.After PCI,the control group received high-dose ticagrelor treatment,and the observation group received low-dose ticagrelor treatment.The therapeutic effects of the two groups were compared.Results Before and after treatment,there were no significant differences in maximum platelet aggregation rate induced by arachidonic acid(AA-MAR),maximum platelet aggregation rate induced by adenosine diphosphate(ADP-MAR)and platelet aggregation rate(PAR)between the two groups(P>0.05);after treatment,AA-MAR,ADP-MAR and PAR in the two groups were lower than those before treatment(P<0.05).Follow up for 1 year,the total incidence of bleeding events in the observation group was 4.69%,which was lower than 15.63%in the control group(P<0.05).Before and after treatment,there were no significant differences in coronary flow velocity reserve(CFVR),diastolic peak velocity(DPV),systolic peak velocity(SPV)and ciastolic time velocity integral(CTVI)between the two groups(P>0.05);after treatment,CFVR,DPV,SPV and CTVI in the two groups were higher than those before treatment(P<0.05).After treatment,the proportion of gradeⅠin the TIMI myocardial perfusion grade(TMPG)grading of the two groups was lower than that before treatment,and the proportion of gradeⅡandⅢwere higher than those before treatment(P<0.05).Conclusion The use of ticagrelor after PCI can inhibit platelet aggregation and improve coronary blood flow and myocardial perfusion,and can also reduce the incidence of bleeding events with low-dose ticagrelor treatment.
作者
徐云鹏
李延江
XU Yunpeng;LI Yanjiang(No.7 Ward of Cardiovascular Internal Medicine Department,Xianyang Hospital of Yan'an University,Xianyang 712000;Cardiology Department,Ansai District People's Hospital of Yan'an,Yan'an 717400,China)
出处
《临床医学研究与实践》
2024年第9期59-62,67,共5页
Clinical Research and Practice
关键词
冠心病
冠心病介入治疗
不同剂量
替格瑞洛
血小板反应
心肌灌注
coronary heart disease
percutaneous coronary intervention
different dose
ticagrelor
platelet reaction
myocardial perfusion
