负荷量替格瑞洛联合普通肝素预处理对急诊PCI后STEMI患者预后的影响  

Effect of loading ticagrelor combined with unfractionated heparin pretreatment on the prognosis of STEMI patients after emergency PCI

作　　者：房勇 邹璐娟 钟钢 刘青平 FANG Yong;ZOU Lujuan;ZHONG Gang;LIU Qingping(Yichun Second People′s Hospital,Yichun,Jiangxi 336000,China)

机构地区：[1]宜春市第二人民医院,江西宜春336000

出　　处：《现代医药卫生》2024年第21期3647-3650,共4页Journal of Modern Medicine & Health

基　　金：江西省宜春市科技计划项目(2023ZDJH2768)。

摘　　要：目的探讨负荷量替格瑞洛联合普通肝素预处理对急诊经皮冠状动脉介入术(PCI)后急性ST段抬高型心肌梗死(STEMI)患者预后的影响。方法选取2018年1月至2022年4月该院收治的102例STEMI患者,按随机数字表法分为对照组、观察组,各51例。比较2组术后冠脉再通率、高血栓负荷率、心功能指标[射血分数(EF)、肌钙蛋白T(CTnT)、氨基末端脑钠肽前体(NT-proBNP)]、围手术期器械使用率、围手术期出血并发症、心血管不良事件(MACE)发生率及病死率。结果观察组冠脉再通率高于对照组,高血栓负荷率低于对照组,差异有统计学意义(P<0.05)。治疗后,2组EF、CTnT、NT-proBNP水平优于治疗前,且观察组优于对照组,差异有统计学意义(P<0.05)。观察组围手术期器械总使用率低于对照组,差异有统计学意义(P<0.05)。2组围手术期出血并发症发生率比较,差异无统计学意义(P>0.05)。观察组MACE发生率与病死率低于对照组,差异有统计学意义(P<0.05)。结论采用负荷量替格瑞洛联合普通肝素预处理治疗急诊PCI后STEMI患者,可提高冠脉再通率,降低高血栓负荷率、围手术期器械使用率、MACE发生率与病死率,改善患者心功能及预后。Objective To investigate the effect of loading ticagrelor combined with unfractionated heparin pretreatment on the prognosis of patients with acute ST-segment elevation myocardial infarction(STEMI)after emergency percutaneous coronary intervention(PCI).Methods A total of 102 STEMI patients admitted to the hospital from January 2018 to April 2022 were selected and divided into the control group and the observation group,51 cases each,according to the randomized numerical table method.The postoperative coronary revascularization rate,high thrombus load rate,cardiac function indexes[ejection fraction(EF),cardiac troponin T(CTnT),N-terminal pro-brain natriuretic peptide(NT-proBNP)],perioperative device utilization,perioperative bleeding complications,incidence of major adverse cardiovascular events(MACE),and morbidity and mortality were compared between the two groups.Results The coronary revascularization rate of the observation group was higher than that of the control group,and the rate of high thrombus load was lower than that of the control group,and the difference was statistically significant(P<0.05).After treatment,the EF,CTnT,and NT-proBNP levels of the 2 groups were better than before treatment,and the observation group was better than the control group,and the difference was statistically significant(P<0.05).The total perioperative instrument utilization rate of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).Comparison of the incidence of perioperative hemorrhage complications between the two groups showed no statistically significant difference(P>0.05).The incidence rate of MACE and morbidity and mortality rate of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).Conclusion The use of loading doses of ticagrelor combined with unfractionated heparin pretreatment in the treatment of STEMI patients after emergency PCI improves coronary recanalization,reduces the rate

关 键 词：心肌梗死 经皮冠状动脉介入术 肝素 预后 

分 类 号：R541[医药卫生—心血管疾病]