替格瑞洛联合瑞替普酶静脉溶栓对老年急性STEMI患者血清RyR2、UCP2水平及心功能的影响  

Influence of ticagrelor combined reteplase intravenous thrombolysis on serum RyR2 and UCP2 levels and cardiac function in aged patients with acute STEMI

作　　者：秦洁 QIN Jie(Department of Cardiology,People's Hospital of Jinzhou City,Jinzhou,Hebei,052260,China)

机构地区：[1]河北省晋州市人民医院心内科

出　　处：《心血管康复医学杂志》2019年第6期741-745,共5页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:研究替格瑞洛联合瑞替普酶(rPA)静脉溶栓对老年急性ST段抬高型心肌梗死(STEMI)患者血清兰尼碱受体2(RyR2)、解偶联蛋白2(UCP2)水平及心功能的影响。方法:2015年12月至2017年12月于我院接受治疗的92例STEMI患者被分为替格瑞洛组(47例)和氯吡格雷组(45例),两组均在阿司匹林、rPA及常规治疗基础上接受相应药物治疗,疗程3个月。观察比较两组治疗后30~120min的冠脉再通率,治疗后血清RyR2、UCP2水平、心功能、不良反应等。结果:随着时间推移,两组冠脉再通率均呈逐渐升高趋势,P<0.05或<0.01,但两组间无显著差异,P均>0.05。与氯吡格雷组比较,替格瑞洛组治疗后血清RyR2[(0.44±0.08)μg/ml比(0.48±0.09)μg/ml]、UCP2[(0.40±0.09)μg/ml比(0.45±0.08)μg/ml]水平、LVEF[(58.56±4.05)%比(61.95±4.63)%]、二尖瓣舒张早期/晚期峰值血流速度比值[E/A,(1.19±0.22)比(1.30±0.24)]均显著升高,LVESd[(51.95±8.64)mm比(47.32±6.49)mm]、LVEDd[(62.36±9.71)mm比(56.72±10.43)mm]、心血管事件发生率(22.22%比6.38%)、平均住院时间[(5.63±1.04)d比(4.92±0.87)d]和出血发生率(28.89%比10.64%)均显著降低,P<0.05或<0.01。结论:替格瑞洛联合rPA静脉溶栓治疗老年STEMI患者的冠脉再通率较高,且能显著改善患者心功能,减少心血管事件和出血发生。Objective:To study influence of ticagrelor combined reteplase(rPA)intravenous thrombolysis on serum levels of ryanodine receptor 2(RyR2)and uncoupling protein 2(UCP2)and cardiac function in aged patients with acute ST elevation myocardial infarction(STEMI).Methods:A total of 92 STEMI patients treated in our hospital from Dec 2015 to Dec 2017 were selected.Patients were divided into ticagrelor group(n=47)and clopidogrel group(n=45)according to therapeutic method,both groups received corresponding medication based on aspirin,rPA and routine treatment for three months.Coronary recanalization rate on 30~120min after treatment,serum levels of RyR2,UCP2 and cardiac function indexes before and after treatment,adverse reaction were observed and compared between two groups.Results:As time went on,coronary recanalization rate gradually rose in two groups,P<0.05 or<0.01,but there was no significant difference between two groups,P>0.05 all.Compared with clopidogrel group after treatment,there were significant rise in serum levels of RyR2[(0.44±0.08)μg/ml vs.(0.48±0.09)μg/ml],UCP2[(0.40±0.09)μg/ml vs.(0.45±0.08)μg/ml],LVEF[(58.56±4.05)%vs.(61.95±4.63)%]and mitral early/late diastolic peak flow velocity[E/A,(1.19±0.22)vs.(1.30±0.24)],and significant reductions in LVESd[(51.95±8.64)mm vs.(47.32±6.49)mm],LVEDd[(62.36±9.71)mm vs.(56.72±10.43)mm],incidence rate of cardiovascular events(22.22%vs.6.38%),mean hospital stay[(5.63±1.04)d vs.(4.92±0.87)d]and incidence rate of hemorrhage(28.89%vs.10.64%)in ticagrelor group,P<0.05 or<0.01.Conclusion:Ticagrelor combined rPA intravenous thrombolysis possesses high coronary recanalization rate in aged STEMI patients.It can significantly improve cardiac function and reduce incidence of cardiovascular events and hemorrhage.

关 键 词：心肌梗死 血栓溶解疗法 替格瑞洛 瑞替普酶 

分 类 号：R542.22[医药卫生—心血管疾病]