经皮冠状动脉介入术前负荷标准剂量替格瑞洛对急性ST段抬高性心肌梗死患者血小板及血管内皮功能影响  

Effect of loading standard dose ticagrelor before PCI on platelet aggregation and vascular endothelial function in patients with acute ST-segment elevation myocardial infarction

作　　者：赵晓强 蒋大军 张峻豪 ZHAO Xiaoqiang;JIANG Dajun;ZHANG Junhao(Department of Cardiology,Zhongrian People's Hospital of Chongqing,Chongqing 404300,China)

机构地区：[1]重庆市忠县人民医院心血管内科,重庆404300

出　　处：《社区医学杂志》2023年第6期284-287,共4页Journal Of Community Medicine

摘　　要：目的探讨经皮冠状动脉介入治疗(PCI)术前负荷标准剂量替格瑞洛对急性ST段抬高性心肌梗死(STEMI)患者血管内皮水平及血小板功能的影响。方法选取2021-01-07-2022-05-21重庆市忠县人民医院收治的123例拟行急诊PCI急性STEMI患者作为研究对象,依据治疗方式不同分为常规组(n=63)和观察组(n=60)。常规组术前给予阿司匹林+氯吡格雷负荷剂量嚼服,观察组术前给予阿司匹林+替格瑞洛负荷剂量嚼服,对比2组患者血小板聚集情况、血管内皮功能、出血事件发生情况。结果观察组术后3个月血小板反应指数(PRI)水平为(47.41±10.54)%,低于常规组的(57.13±9.32)%,F=1427.606,P<0.001;血小板最大聚集率(MPAR)水平为(40.16±4.23)%,低于常规组的(47.93±4.68)%,F=4023.316,P<0.001。观察组术后3个月内皮素-1(ET-1)水平为(25.47±10.62)pg/mL,低于常规组的(39.43±13.27)pg/mL,F=1316.305,P<0.001;一氧化氮(NO)水平为(92.86±8.24)μmol/L,高于常规组的(80.57±9.73)μmol/L,F=798.569,P<0.001。观察组出血事件发生率为11.67%(7/60),高于常规组的7.94%(5/63),但差异无统计学意义,χ^(2)=0.486,P=0.486。结论PCI术前负荷标准剂量替格瑞洛可改善急性STEMI患者血管内皮功能,调节血小板聚集情况,且不增加出血事件发生。Objective To investigate the effects of loading standard dose ticagrelor before percutaneous coronary intervention(PCI)on vascular endothelial level and platelet function in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods A total of 123 patients with acute STEMI in Zhongxian People’s Hospital of Chongqing from January 7,2021 to May 21,2022 were selected as the research objects and divided into conventional group(n=63)and experimental group(n=60)according to different treatment methods.The conventional group was given a load dose of aspirin and clopidogrel before operation,while the experimental group was given a load dose of aspirin and ticagrelor before operation.Platelet aggregation,vascular endothelial function and bleeding events were compared between the two groups.Results The platelet response index(PRI)level in the experimental group was(47.41±10.54)%,lower than that in the conventional group(57.13±9.32)%,F=1427.606,P<0.001;The maximum platelet aggregation rate(MPAR)was(40.16±4.23)%,lower than that in the conventional group(47.93±4.68)%,F=4023.316,P<0.001.The level of endothelin-1(ET-1)in the experimental group was(25.47±10.62)pg/ml,lower than that in the conventional group(39.43±13.27)pg/ml,F=1316.305,P<0.001;The nitric oxide(NO)level was(92.86±8.24)μmol/L,higher than that in the conventional group(80.57±9.73)μmol/L,F=798.569,P<0.001.The incidence of bleeding events in the experimental group was 11.67%(7/60)higher than that in the conventional group 7.94%(5/63),and there was no statistically significant difference,χ^(2)=0.486,P=0.486.Conclusion Standard dose of ticagrelor before PCI can improve vascularen dothelial function,regulate platelet aggregation,but do not increase bleeding events in acute STEMI.

关 键 词：经皮冠状动脉介入治疗 替格瑞洛 ST段抬高性心肌梗死 血管内皮功能 血小板聚集 

分 类 号：R542.22[医药卫生—心血管疾病]