摘要
目的探讨不同抗栓治疗方案对老年非ST段抬高型心肌梗死(NSTEMI)并心房颤动(AF)患者的疗效。方法将80例NSTEMI并AF患者根据抗栓治疗方案的不同分为A组(20例,华法林)、B组(20例,阿司匹林+替格瑞洛)、C组(20例,华法林+替格瑞洛)、D组(20例,华法林+阿司匹林+替格瑞洛),比较四组患者的疗效。结果D组的出血发生率高于A、B、C组(P<0.05);C组的血栓栓塞发生率低于A、B、D组,且D组低于A、B组(P<0.05);C组的MACE发生率低于A组(P<0.05)。治疗后,四组的CRUSADE、TIMI评分及改良EHRA评分均降低(P<0.05);治疗后,D组CRUSADE评分高于A、B、C组(P<0.05);治疗后,D组TIMI评分及改良EHRA评分低于A、B、C组,且C组低于A、B组(P<0.05)。治疗后,四组的CK-MB、cTnT、BNP水平及LD1/LD2均降低(P<0.05)。结论不同抗栓治疗方案对NSTEMI并AF患者的疗效存在差异,临床需结合患者自身实际情况选择适宜的抗栓治疗方案,且在治疗过程中,需尽量避免发生出血与血栓栓塞,有助于患者获得良好的预后。
Objective To investigate the therapeutic effect of different antithrombotic therapy on elderly patients with non-ST-segment elevation myocardial infarction(NSTEMI)and atrial fibrillation(AF).Methods Eighty patients with NSTEMI and AF were divided into group A(20 cases,warfarin),group B(20 cases,aspirin+tegrilo),group C(20 cases,warfarin+tigrillo),and group D(20 cases,warfarin+aspirin+tigrillo)according to the different antithrombotic therapy programs.The therapeutic effects of the four groups were compared.Results The incidence of bleeding in the group D were higher than that in the group A,B and C(P<0.05);the incidence of thromboembolism in the group C were lower than that in the group A,B and D,and that in the group D were lower than that in the group A and B(P<0.05);the incidence of MACE in the group C was lower than that in the group A(P<0.05).After treatment,CRUSADE,TIMI scores and improved EHRA scores of the four groups decreased(P<0.05);after treatment,CRUSADE score of the group D were higher than that of the group A,B and C(P<0.05);after treatment,TIMI score and improved EHRA score in the group D were lower than those in the group A,B and C,and those in the group C were lower than the group A and B(P<0.05).After treatment,the levels of CK-MB,cTnT,BNP and LD1/LD2 in the four groups decreased(P<0.05).Conclusion Different antithrombotic therapy programs have different effects on patients with NSTEMI and AF.It is necessary to choose appropriate antithrombotic therapy programs according to the actual situation of patients in clinic.In the course of treatment,hemorrhage and thromboembolism should be avoided as far as possible to help patients obtain a good prognosis.
作者
王智刚
宋睿
WANG Zhi-gang;SONG Rui(Xi'an International Medical Center Hospital,Xi'an 710100;Xianyang Hospital of Yan'an University,Xianyang 712000,China)
出处
《临床医学研究与实践》
2019年第30期62-64,共3页
Clinical Research and Practice
关键词
抗栓治疗
非ST段抬高型心肌梗死
心房颤动
antithrombotic therapy
non-ST-segment elevation myocardial infarction
atrial fibrillation
