替格瑞洛联合冻干重组人脑利钠肽对急性ST段抬高型心肌梗死行介入治疗患者炎性因子、血小板功能及预后的影响  

Influence of tigliellol combined with lyophilized recombinant human brain natriuretic peptide on the inflammatory factors,platelet function and prognosis in the patients receiving interventional therapy for acute ST-segment elevation myocardial infarction

作　　者：鲁叶弘[1] 王雅心[2] 付强[3] 王占胜[3] LU Ye-hong;WANG Ya-xin;FU Qiang;WANG Zhan-sheng(Department of Cadres Cardiology,Fourth People's Hospital of Shenyang,Shenyang 110031,China;Department of Emergency,Fourth People's Hospital of Shenyang,Shenyang 110031,China;Department of Cardiology,Fourth People's Hospital of Shenyang,Shenyang 110031,China)

机构地区：[1]沈阳市第四人民医院干诊心内科,沈阳110031 [2]沈阳市第四人民医院急诊科,沈阳110031 [3]沈阳市第四人民医院心内科,沈阳110031

出　　处：《实用药物与临床》2018年第12期1364-1368,共5页Practical Pharmacy and Clinical Remedies

摘　　要：目的分析替格瑞洛联合冻干重组人脑利钠肽对急性ST段抬高型心肌梗死(STMEI)行介入治疗患者的炎性因子、血小板功能及预后的影响。方法选择我院2013年12月至2017年3月收治的108例STEMI患者,两组均给予经皮冠状动脉介入(PCI),按随机数字表法分为对照组(52例)和观察组(56例)。对照组应用替格瑞洛治疗,观察组在对照组基础上联合冻干重组人脑利钠肽治疗。比较两组术后2 h无复流情况,治疗前及治疗7 d后的血小板功能、炎性因子、心功能,以及随访12个月内心血管事件的发生情况。结果术后2 h,观察组的心肌无复流率低于对照组(5. 36%vs. 19. 23%,P <0. 05)。治疗前,两组血小板功能、炎性因子比较差异无统计学意义(P> 0. 05)。治疗7 d后,两组血小板功能、炎性因子、肌钙蛋白I(c Tn I)、肌酸激酶同工酶(CKMB)均降低,左室射血分数(LVEF)均升高,两组比较差异有统计学意义(P <0. 05)。随访12个月,两组均有严重心律失常、心力衰竭、顽固性心绞痛、再发心肌梗死、心源性死亡发生,且观察组总发生率低于对照组(P <0. 05)。结论替格瑞洛联合冻干重组人脑利钠肽对STMEI行PCI治疗者的效果确切,能够减轻炎症反应,提高血小板水平及心脏功能,降低心脏不良事件发生率,改善预后。Objective To analyze the influence of tigliellol combined with lyophilized recombinant human brain natriuretic peptide on the inflammatory factors,platelet function and prognosis in the patients receiving interventional therapy for acute ST-segment elevation myocardial infarction(STMEI).Methods Totally108patients with STEMI in our hospital from December2013to March2017were divided into control group(n=52)and observation group(n=56)according to random numbers table.All patients underwent PCI.Control group was treated with tigliellol,and observation group was treated with lyophilized recombinant human brain natriuretic peptide combined with tigliellol.The condition of no reflow at2h after operation,and the platelet function,inflammatory factor,cardiac function before and after7days of treatment,and the occurrence of cardiovascular events within12months of follow-up in both groups were compared.Results At2h after operation,the rate of no-reflow in observation group was lower than that in control group(5.36%vs.19.23%<0.05).Before treatment,there was no significant difference in platelet function or inflammatory factors between the two groups(P>0.05).After7days of treatment,the levels of platelet function and inflammatory factors,troponin I(cTnl)and creatine enzyme isoenzyme(CK-MB)in both groups were decreased,while the left ventricular ejection fraction(LVEF)was increased(P<0.05),and there were significant differences between the two groups(P<0.05).Severe arrhythmia,heart failure,intractable angina,recurrent myocardial infarction and cardiac death occurred in the two groups during the12-month follow-up,and the total rate in observation group was lower(P<0.05).Conclusion Ticagrelor combined with lyophilized recombinant human brain natriuretic peptide has good efficacy in the treatment of STMEI patients with PCI,which can reduce inflammation,platelet and improve cardiac function,reduce the incidence of cardiac adverse events,and improve the prognosis.

关 键 词：急性ST段抬高型心肌梗死 介入治疗 替格瑞洛 冻干重组人脑利钠肽 预后 

分 类 号：R542.22[医药卫生—心血管疾病]