替格瑞洛剂量选择对AMI患者PCI术后再缺血患者TIMI分级的影响  

Effect of ticagrelor dose selection on TIMI classification in AMI patients with reischemia after PCI

作　　者：杜发强 杜亚楠 莫胜建 DU Faqiang;DU Yanan;MO Shengjian(Department of Cardiovascular Medicine,Zhoukou People's Hospital,Zhoukou,Henan 466000,China)

机构地区：[1]周口市人民医院心血管内科,河南周口466000

出　　处：《中国医学工程》2022年第11期104-107,共4页China Medical Engineering

摘　　要：目的研究替格瑞洛剂量选择对急性心肌梗死(AMI)患者经皮冠状动脉介入(PCI)术后再缺血患者TIMI分级的影响。方法前瞻性将周口市人民医院收治的92例行PCI术的AMI患者(2020年4月至2021年4月)采用随机信封法分为研究组、参照组。参照组46例治疗方案采用常规剂量替格瑞洛,研究组46例治疗方案采用负荷剂量替格瑞洛。对比两组TIMI分级情况、乳酸脱氢酶(LDH)、冠脉血流储备(CFVR)、平均血小板体积(MPV)、左前降支收缩期血流峰值(SPV)、肌红蛋白(CK-MB)、左前降支舒张期血流峰值(DPV)、心肌肌钙蛋白Ⅰ(cTnⅠ)、C反应蛋白(CRP)、降钙素原(PCT)、α-羟酸脱氢酶(HBDH)、血小板计数(PLT)、白介素-6(IL-6)、血小板聚集率(PAR)。结果治疗7 d后,两组TIMI分级均≥2级,且研究组TIMI血流分级优于参照组(P<0.05);治疗7 d后,研究组DPV、CFVR、SPV水平较参照组高(P<0.05);治疗7 d后,研究组cTnⅠ、PLT、CK-MB、PAR、HBDH、MPV、LDH水平较参照组降低;治疗7 d后,研究组IL-6、PCT、CRP水平低于参照组(P<0.05)。结论负荷剂量替格瑞洛治疗经PCI术AMI患者可有效抗血小板凝集,增加冠脉血流,改善TIMI分级,从而改善心功能。【Objective】To study the effect of ticagrelor dose selection on TIMI classification in acute myocardial infarction(AMI)patients with reischemia after percutaneous coronary intervention(PCI).【Methods】A total of 92 AMI patients(April 2020 to April 2021)admitted to Zhoukou People's Hospital who underwent PCI were prospectively divided into a study group and a reference group by random envelope method.Forty-six patients in the reference group were treated with conventional dose ticagrelor,and 46 patients in the study group were treated with loading dose of ticagrelor.The TIMI grading,lactate dehydrogenase(LDH),coronary blood flow reserve(CFVR),mean platelet volume(MPV),peak systolic blood flow(SPV)in the left anterior descending artery,and myoglobin(CK-MB),left anterior descending bronchial peak diastolic blood flow(DPV),cardiac troponin I(cTnI),C-reactive protein(CRP),procalcitonin(PCT),alpha-hydroxy acid dehydrogenase(HBDH),platelets count(PLT),interleukin-6(IL-6),platelet aggregation rate(PAR)were compared between the two groups.【Results】After 7 days of treatment,the TIMI grades in both groups were≥2,and the TIMI blood flow grade in the study group was better than that in the reference group(P<0.05).After 7 days of treatment,the levels of DPV,CFVR and SPV in the study group were higher than those in the reference group(P<0.05).After 7 days of treatment,the levels of cTnⅠ,PLT,CK-MB,PAR,HBDH,MPV and LDH in the study group were lower than those in the reference group.After 7 days of treatment,the levels of IL-6,PCT and CRP in the study group were lower than those in the reference group(P<0.05).【Conclusion】Loading dose ticagrelor in the treatment of patients with AMI after PCI can effectively prevent platelet aggregation,increase coronary blood flow,improve TIMI classification,and thus improve cardiac function.

关 键 词：急性心肌梗死 替格瑞洛 TIMI分级 血小板 

分 类 号：R542.22[医药卫生—心血管疾病]