不同负荷剂量替格瑞洛对急性心肌梗死多支病变患者PCI术后溶栓分级及RhoA/Rho激酶活性的影响  

Effects of different loading doses of ticagrelor on thrombolysis grade and RhoA/Rho kinase activity in patients with acute myocardial infarction and multivessel disease after PCI

作　　者：任琳[1] 王倩[2] 陈皓 赵甲彧 马利祥[1] REN Lin;WANG Qian;CHEN Hao;ZHAO Jiayu;MA Lixiang(Department of Cardiovascular Medicine,Qinhuangdao First Hospital,Qinhuangdao Hebei 660000,China)

机构地区：[1]秦皇岛市第一医院心血管内科,河北秦皇岛660000 [2]秦皇岛市第一医院老年病科,河北秦皇岛660000

出　　处：《中国急救复苏与灾害医学杂志》2024年第12期1618-1621,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：河北省秦皇岛市科技计划项目(编号:201805A096)。

摘　　要：目的探讨不同负荷剂量替格瑞洛对急性心肌梗死(AMI)多支病变患者经皮冠状动脉介入治疗(PCI)术后心肌梗死溶栓(TIMI)分级及RAS同源基因家族成员(Rho)A/Rho激酶通路的影响。方法选取2020年1月—2022年1月秦皇岛市第一医院收治的100例AMI多支病变患者,按照药物的不同剂量进行分组。对照组予以90 mg负荷剂量替格瑞洛,观察组予以180 mg负荷剂量替格瑞洛。比较两组治疗前(入院即刻)、治疗后(PCI术后1年)TIMI分级、血小板参数、炎症反应指标[降钙素原(PCT)、C反应蛋白(CRP)、白细胞介素-6(IL-6)]、心肌酶谱[肌钙蛋白I(cTnI)、肌红蛋白(Mb)、乳酸脱氢酶(LDH)]及RhoA/Rho激酶通路活性。结果治疗后观察组TIMI分级优于对照组(H=2.120,P<0.05);治疗后观察组血小板计数、平均血小板体积低于对照组(t=7.639、4.838,P<0.05),但两组血小板压积比较,差异无统计学意义(P>0.05);治疗后观察组CRP、PCT、IL-6、cTnI、LDH、MB、RhoA、Rho激酶活性低于对照组(t=21.698、21.372、12.855、14.564、16.851、20.338、8.024、4.949,P<0.05)。结论AMI多支病变患者PCI术后接受负荷剂量替格瑞洛可改善TIMI血流分级,并有效缓解机体炎症反应、心肌酶损伤,其作用机制可能与RhoA/Rho激酶通路有关。Objective To investigate the effect of tegretol dose selection on thrombolysis in myocardial infarction(TIMI)grading and RAS homologous gene family member(Rho)A/Rho kinase pathway after percutaneous coronary intervention(PCI)in patients with acute myocardial infarction(AMI)with multiple lesions.Methods A total of 100 patients with AMI multi-branch lesions admitted to our hospital from January 2020 to January 2022 were selected and randomly divided into 2 groups..The control group was given regular dose of Tegretol and the observation group was given loading dose of Tegretol.The TIMI classification,platelet parameters,inflammatory response indexes[calcitoninogen(PCT),C-reactive protein(CRP),interleukin-6(IL-6)],myocardial enzyme profile[troponin I(cTnI),myoglobin(Mb),lactate dehydrogenase(LDH)]and RhoA/Rho kinase pathway activity were compared between the two groups before treatment(immediately after admission)and after treatment(1 year after PCI).Results After treatment,the TIMI classification of the observation group was better than that of the control group(H=2.120,P<0.05);after treatment,the platelet count and mean platelet volume of the observation group were lower than those of the control group(t=7.639,4.838,P<0.05),and there was no statistically significant difference between the two groups in terms of platelet pressure(P>0.05);after treatment,the CRP,PCT,IL-6,cTnI,LDH,MB,RhoA,Rho kinase activity were lower than those of the control group(t=21.698,21.372,12.855,14.564,16.851,20.338,8.024,4.949,P<0.05).Conclusion Patients with multiple AMI lesions receiving loading doses of tegretol after PCI can improve TIMI flow grading and effectively alleviate the inflammatory response and myocardial enzyme damage in the body,and the mechanism of action may be related to the RhoA/Rho kinase pathway.

关 键 词：替格瑞洛 急性心肌梗死 PCI TIMI分级 RhoA/Rho激酶通路 

分 类 号：R542.22[医药卫生—心血管疾病]