不同剂量替格瑞洛对心肌梗死患者经皮冠状动脉介入治疗术后不良反应及血清水平的影响  

Impact of different doses of ticagrelor on adverse reactions and serum indexes levels in patients with myocardial infarction after percutaneous coronary intervention

作　　者：曹利波[1] 韩利平 杨昊煜 贾东丽 CAO Li-bo;HAN Li-ping;YANG Hao-yu;JIA Dong-li(Department of Pharmacy,Handan First Hospital,Handan,Hebei 056002,China)

机构地区：[1]邯郸市第一医院药学部,河北省邯郸市056002

出　　处：《中国心血管病研究》2025年第2期133-139,共7页Chinese Journal of Cardiovascular Research

基　　金：河北省2022年度医学科学研究课题(20220488)。

摘　　要：目的探讨不同剂量替格瑞洛对心肌梗死患者经皮冠状动脉介入治疗(PCI)术后不良反应及病情相关指标的影响。方法选取2021年1月~2023年1月于邯郸市第一医院接受PCI术的心肌梗死患者186例,按照随机数字表法分为常规剂量组(n=93)、小剂量组(n=93),常规剂量组予以常规剂量替格瑞洛治疗(90 mg/次),小剂量组予以小剂量替格瑞洛治疗(45 mg/次)。比较两组心功能[左心室收缩末期内径(LVESD)、左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)]、冠状动脉血流相关指标[舒张期血流峰值(DPV)、舒张期时间速度积分(CTVI)、冠状动脉血流速度储备(CFVR)、收缩期血流峰值(SPV)]、血小板功能[花生四稀酸诱导的血小板最大聚集率(AA-MAR)、血小板最大聚集率(MPAR)、二磷酸腺苷诱导的血小板最大聚集率(ADP-MAR)]、病情相关指标{血清可溶性细胞间黏附分子(sICAM-1)、脂蛋白a[Lp(a)]、可溶性血管细胞黏附分子(sVCAM-1)、钙卫蛋白A4(S100A4)}及主要不良心血管事件(MACE)、出血事件。结果治疗3个月后,常规剂量组LVEF明显高于小剂量组[(57.32±1.24)%,比(54.79±1.09)%,P<0.05],LVESD、LVEDD明显低于小剂量组[(32.29±1.39)mm比(36.83±1.58)mm、(50.13±2.35)mm比(54.36±2.54)mm,P<0.05],但治疗6个月后两组间比较无明显差异(P>0.05);治疗3个月后,常规剂量组的DPV、CTVI、CFVR、SPV明显高于小剂量组[(34.18±2.16)cm/s比(30.56±1.82)cm/s、(23.05±1.45)比(19.74±1.39)、(3.49±0.32)比(3.02±0.30)、(16.81±1.06)cm/s比(14.76±1.00)cm/s,P<0.05],但治疗6个月后两组间比较无明显差异(P>0.05);治疗3个月后,常规剂量组的AA-MAR、MPAR、ADP-MAR明显低于小剂量组(P<0.05),但治疗6个月后两组间比较无明显差异(P>0.05);治疗3个月后,常规剂量组血清sICAM-1、Lp(a)、sVCAM-1、S100A4水平明显低于小剂量组[(387.25±16.58)μg/L比(425.63±21.36)μg/L、(196.25±14.94)mg/L比(224.76±17.66)mg/L、(247.07±10.15)μg/L比(258.Objective To investigate the effects of different doses of ticagrelor on adverse reactions and disease-related serum indicators in patients with myocardial infarction after percutaneous coronary intervention(PCI).Methods A total of 186 patients with myocardial infarction who underwent PCI in our hospital from January 2021 to January 2023 were selected and randomly divided into the convention dose group(n=93)and the low dose group(n=93)according to a random number table method.The conventional dose group was treated with conventional dose ticagrelor(90 mg/time),while the low dose group was treated with low dose ticagrelor(45 mg/time).The cardiac function[left ventricular end-systolic diameter(LVESD),left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD)],coronary flow-related indicators[diastolic peak flow velocity(DPV),coronary time velocity integral(CTVI),coronary flow velocity reserve(CFVR),systolic peak flow velocity(SPV)],platelet function[arachidonic acid-induced maximum platelet aggregation rate(AA-MAR),maximum platelet aggregation rate(MPAR),adenosine diphosphate-induced maximum platelet aggregation rate(ADP-MAR)],disease-related indicators{serum soluble intercellular adhesion molecule(sICAM-1),lipoprotein a[Lp(a)],soluble vascular cell adhesion molecule(sVCAM-1),calprotectin A4(S100A4)},major adverse cardiovascular events(MACE)and bleeding events were compared between the two groups.Results After 3 months of treatment,the LVEF in the conventional dose group was significantly larger than that in the low dose group[(57.32±1.24)%vs.(54.79±1.09)%,P<0.05].The LVESD and LVEDD were significantly smaller than those in the low-dose group(32.29±1.39)mm vs.(36.83±1.58)mm,(50.13±2.35)mm vs.(54.36±2.54)mm,P<0.05].However,there was no significant difference between the two groups after 6 months of treatment(P>0.05).After 3 months of treatment,the DPV,CTVI,CFVR and SPV in the conventional dose group were significantly higher than those in the low dose group[(34.18±2.16)cm/s vs.(30

关 键 词：心肌梗死 经皮冠状动脉介入治疗 替格瑞洛 心功能 主要不良心血管事件 出血事件 

分 类 号：R542.22[医药卫生—心血管疾病]