氯吡格雷联合替格瑞洛对急性ST段抬高型心肌梗死患者OCT指标的影响  

Effect of Clopidogrel Combined with Telgrello on the OTC Indexes in Patients with ST-Segment Elevation Myocardial Infarction

作　　者：徐书灿[1] 黎叶飞[2] 张永林[1] 刘爱军[1] XU Shucan;LI Yefei;ZHANG Yonglin;LIU Aijun(Binhai County People′s Hospital,Yancheng,Jiangsu,China 224500;The Second Affiliated Hospital of Nantong University,Nantong,Jiangsu,China 226001)

机构地区：[1]江苏省滨海县人民医院,江苏盐城224500 [2]南通大学第二附属医院,江苏南通226001

出　　处：《中国药业》2024年第15期95-98,共4页China Pharmaceuticals

基　　金：江苏省卫生健康委员会科研项目[H20210763]。

摘　　要：目的基于光学相干断层成像(OCT)指标探讨氯吡格雷联合替格瑞洛对急性ST段抬高型心肌梗死(STEMI)患者动脉粥样硬化斑块稳定性的影响。方法回顾性选取江苏省滨海县人民医院2020年1月至2023年1月收治的急性STEMI患者105例,根据治疗方案的不同分为常规组(52例)和联合组(53例)。两组患者均予氯吡格雷治疗,联合组患者加用替格瑞洛,均治疗12个月。结果联合组患者的总有效率为84.91%,显著高于常规组的65.38%(P<0.05)。治疗后,联合组患者的最小纤维帽厚度显著大于常规组(P<0.05),脂质弧度显著小于常规组(P<0.05),且联合组的改善幅度均显著大于常规组(P<0.05);两组患者的最小管腔面积无显著差异(P>0.05),但联合组最小管腔面积增大量显著高于常规组(P<0.05);两组患者的全血黏度、血浆黏度、血细胞比容均显著降低(P<0.05),且联合组均显著低于常规组(P<0.05)。联合组患者的不良反应发生率为5.66%,显著低于常规组的19.23%(P<0.05)。结论氯吡格雷联合替格瑞洛治疗急性STEMI的临床疗效良好,可改善患者动脉粥样硬化斑块的稳定性,促进血管功能恢复,且安全性良好。Objective To investigate the effect of clopidogrel combined with ticagrelor on the stability of atherosclerotic plaque in patients with acute ST-segment elevation myocardial infarction(STEMI) based on optical coherence tomography(OCT).Methods A total of 105 patients with acute STEMI admitted to the Binhai County People′s Hospital from January 2020 to January 2023 were retrospectively selected and divided into the conventional group(52 cases) and the combined group(53 cases)according to different treatment regimens.The patients in the two groups were treated with clopidogrel,on this basis,the patients in the combined group were treated with ticagrelor.Both groups were treated for 12 months.Results The total effective rate in the combined group was 84.91%,which was significantly higher than 65.38% in the conventional group(P < 0.05).After treatment,the minimum fiber cap thickness in the combined group was significantly greater than that in the conventional group(P < 0.05),while the lipid radian in the combined group was significantly smaller than that in the conventional group(P < 0.05),and the improvement in the combined group was significantly greater than that in the conventional group(P < 0.05).There was no significant difference in the minimum luminal area between the two groups(P > 0.05),but the increase in minimum luminal area in the combined group was significantly higher than that in the conventional group(P < 0.05).The whole blood viscosity,plasma viscosity,and hematocrit in the two groups significantly decreased(P < 0.05),and those in the combined group were significantly lower than those in the conventional group(P < 0.05).The incidence of adverse reactions in the combination group was 5.66%,which was significantly lower than 19.23% in the conventional group(P < 0.05).Conclusion Clopidogrel combined with ticagrelor has good clinical efficacy and safety in the treatment of acute STEMI,which can improve the stability of atherosclerotic plaque,and promote the recovery of vascular function.

关 键 词：氯吡格雷 替格瑞洛 急性ST段抬高型心肌梗死 光学相干断层成像 动脉粥样硬化斑块稳定性 

分 类 号：R969.4[医药卫生—药理学] R973[医药卫生—药学]