不同剂量替格瑞洛在急性心肌梗死PCI术后的应用效果分析  

Analysis on application effect of different doses of ticagrelor after PCI in acute myocardial infarction

作　　者：路营辉 LU Yinghui(First Department of Cardiovascular Medicine,General Hospital of Pingmei Shenma Medical Group,Pingdingshan,Henan 467000,China)

机构地区：[1]平煤神马医疗集团总医院心血管内科一区,河南平顶山467000

出　　处：《检验医学与临床》2024年第6期762-765,769,共5页Laboratory Medicine and Clinic

摘　　要：目的研究不同剂量替格瑞洛在急性心肌梗死经皮冠状动脉介入(PCI)术后的应用效果。方法选取2021年5月至2022年9月该院收治的100例行PCI术的急性心肌梗死患者为研究对象,根据治疗方案将患者分为常规组、研究组,每组50例。常规组PCI术后采用常规剂量替格瑞洛治疗,研究组PCI术后采用负荷剂量替格瑞洛治疗。比较术前、术后7 d两组TIMI血流分级、心功能指标[左室舒张末期内径(LVEDD)、左室射血分数(LVEF)、左室收缩末期内径(LVESD)]、血管内皮功能指标[循环内皮细胞(CEC)、血管性假血友病因子(vWF)、内皮素1(ET-1)、一氧化氮(NO)]及血清白细胞介素-8(IL-8)、白细胞介素-1β(IL-1β)、降钙素原(PCT)、粒巨噬细胞集落刺激因子受体α(CSF2RA)水平,比较两组不良心血管事件发生率。结果术后7 d研究组TIMI血流分级优于常规组(P<0.05)。术后7 d研究组LVESD、LVEDD小于常规组(P<0.05),LVEF高于常规组(P<0.05)。术后7 d研究组外周血CEC数量及血清vWF、ET-1水平低于常规组(P<0.05),血清NO水平高于常规组(P<0.05)。术后7 d研究组血清IL-8、IL-1β、PCT、CSF2RA水平低于常规组(P<0.05)。研究组不良心血管事件发生率[4.00%(2/50)]与常规组[8.00%(4/50)]相比,差异无统计学意义(P>0.05)。结论PCI术治疗急性心肌梗死患者后采取负荷剂量替格瑞洛治疗可有效调节患者TIMI血流分级,改善患者心功能及血管内皮功能,促进病情恢复,且未增加心血管不良事件发生风险。Objective To study the application effect of different doses of ticagrelor after percutaneous coronary intervention(PCI) for acute myocardial infarction.Methods One hundred patients with acute myocardial infarction admitted and treated by PCI in this hospital from May 2021 to September 2022 were selected as the research subjects and divided into the conventional group and research group according to the treatment plan,50 cases in each group.The conventional group adopted the conventional dose of ticagrelor treatment after PCI,while the study group adopted the load dose of ticagrelor treatment after PCI.The TIMI blood flow grade,cardiac function indexes [left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),left ventricular end-systolic diameter(LVESD)],vascular endothelial function indexes [circulating endothelial cells(CEC),von Willebrands factor(vWF),endothelin 1(ET-1),nitric oxide(NO)],levels of serum interleukin-8(IL-8),interleukin-1β(IL-1β),procalcitonin(PCT) and macrophage colony-stimulating factor receptor α(CSF2RA) before operation and on postoperative 7 d and the incidence rate of adverse cardiovascular events were compared between the two groups.Results The blood flow grade on postoperative 7 d in the research group was better than that in the conventional group(P<0.05).LVESD and LVEDD on postoperative 7 d in the research group were lower than those in the conventional group,while LVEF in the study group was higher than that in the conventional group(P<0.05).The levels of peripheral blood CEC,serum vWF and ET-1 on postoperative 7 d in the research group were lower than those in the conventional group(P<0.05),and the serum NO level was higher than that in the conventional group(P<0.05).The levels of serum IL-8,IL-1β,PCT and CSF2RA on postoperative 7 d in the research group were lower than those in the conventional group(P<0.05).The incidence rate of adverse cardiovascular events in the research group was 4.00%(2/50),which in the conventional group was 8.00%(4/50),and

关 键 词：替格瑞洛 急性心肌梗死 经皮冠状动脉介入 循环内皮细胞 粒巨噬细胞集落刺激因子受体α 

分 类 号：R542.22[医药卫生—心血管疾病]