替格瑞洛在ASTEMI患者急诊PCI治疗中的作用  

Role of ticagrelor during emergency PCI in ASTEMI patients

作　　者：蒋思源[1] 张馥 曾伯石 JIANG Si-yuan;ZHANG Fu;ZENG Bo-shi(Department of Emergency,Xiaogan City Central Hospital,Xiaogan,Hubei,432000,China)

机构地区：[1]孝感市中心医院急诊科,湖北孝感432000

出　　处：《心血管康复医学杂志》2021年第3期297-300,共4页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:研究替格瑞洛在急性ST段抬高型心肌梗死(ASTEMI)患者急诊经皮冠状动脉介入治疗(PCI)中的作用。方法:本院2016年1月~2019年1月收治的200例ASTEMI患者被随机均分为氯吡格雷组和替格瑞洛组,两组均在PCI术前服用阿司匹林,并在围术期接受相应药物治疗。观察比较两组术后TIMI血流分级,术后2h心电图ST段回落情况,术前、术后14d的左室高峰充盈率(LVPFR)、左室高峰射血率(LVPER)、LVEF和二尖瓣舒张早期/晚期峰值流速比值(E/A);随访6个月,比较两组不良反应和不良心血管事件发生率。结果:与氯吡格雷组比较,替格瑞洛组PCI术后TIMI 3级率(52%比76%),P=0.001;替格瑞洛组术后2h心电图ST段完全回落率(30%比63%),P=0.001;术后14d替格瑞洛组LVPFR[(1.90±0.26)EDV/s比(2.10±0.31)EDV/s]、LVPER[(1.70±0.15)EDV/s比(1.82±0.15)EDV/s]、LVEF[(55.17±4.41)%比(58.99±5.83)%]和E/A[(1.41±0.16)比(1.49±0.15)]显著升高,P均=0.001。随访6个月,与氯吡格雷组比较,替格瑞洛组不良反应(24%比6%)和不良心血管事件(22%比4%)发生率均显著降低,P均=0.001。结论:替格瑞洛应用于急性ST段抬高型心肌梗死患者急诊PCI治疗中,可显著提高临床疗效,改善心功能,降低预后不良心血管事件发生风险。Objective:To study role of ticagrelor in patients with acute ST segment elevation myocardial infarction(ASTEMI)during emergency percutaneous coronary intervention(PCI).Methods:A total of 200 ASTEMI patients treated in our hospital from Jan 2016 to Jan 2019 were randomly and equally divided into clopidogrel group and ticagrelor group.Both groups received aspirin before PCI,and received corresponding medication during perioperative period.Postoperative TIMI blood flow grade,ST segment regression on ECG 2h after PCI,left ventricular peak filling rate(LVPFR),left ventricular peak ejection rate(LVPER),LVEF and mitral early/late diastolic peak flow velocity ratio(E/A)before and 14d after PCI were observed and compared between two groups;after six-month follow-up,incidence rates of adverse reactions and adverse cardiovascular events were compared between two groups.Results:After PCI,compared with clopidogrel group,the TIMI grade 3 rate(52%vs.76%),complete ST segment regression rate on ECG 2h(30%vs.63%)significantly rose;on 14d after PCI,the LVPFR[(1.90±0.26)EDV/s vs.(2.10±0.31)EDV/s],LVPER[(1.70±0.15)EDV/s vs.(1.82±0.15)EDV/s],LVEF[(55.17±4.41)%vs.(58.99±5.83)%]and E/A[(1.41±0.16)vs.(1.49±0.15)]significantly rose in ticagrelor group,P=0.001 all.Compared with clopidogrel group after six-month follow-up,there were significant reductions in incidence rates of adverse reactions(24%vs.6%)and adverse cardiovascular events(22%vs.4%)in ticagrelor group,P=0.001 both.Conclusion:Ticagrelor can significantly improve therapeutic effect and heart function,reduce risk of adverse cardiovascular events with good safety when applied during emergency PCI in ASTEMI patients.

关 键 词：心肌梗死 血管成形术 气囊 冠状动脉 替格瑞洛 

分 类 号：R542.22[医药卫生—心血管疾病]