摘要
目的:研究替格瑞洛与氯吡格雷对急性心肌梗死冠脉介入术后血小板聚集的影响。方法:将2017年5月至2018年5月本院收治的急性心肌梗死冠脉介入治疗患者102例依随机数表法分为对照组和观察组,每组51例。对照组患者采用氯吡格雷(75 mg•次-1,1次•d-1,口服治疗,连续治疗12 M)治疗,观察组给予替格瑞洛(90 mg•次-1,2次•d-1,口服治疗,连续治疗12 M)治疗。治疗前与治疗12 M后分别使用无创血液动力学检测仪检测每搏输出量(Stroke volume,SV)、左心室射血分数(Left ventricular ejection fraction,LVEF)、左心室舒张末期内径(Left ventricular end diastolic diameter,LVEDD)、左心室收缩末期容积(Left ventricular end systolic volume,LVESV),并测定患者血小板聚集率,同时记录并对比两组患者在治疗12 M过程中主要心血管不良事件(Major adverse Cardiovascular events,MACE)及药物不良反应发生情况。结果:与治疗前相比,两组的SV、LVEF水平均明显增加(P<0.05),其中观察组更为显著(P<0.05);各治疗组的LVEDD、LVESV水平均明显降低(P<0.05),其中观察组更为显著(P<0.05);与治疗前相比,各治疗组的血小板聚集率均明显降低(P<0.05),其中观察组更为显著(P<0.05);观察组MACE事件发生率与不良反应总发生率均低于对照组(P<0.05)。结论:冠脉介入术后对急性心肌梗死患者使用替格瑞洛治疗,可达更好的心功能改善效果,对血小板聚集抑制作用更显著,且术后MACE事件及药物不良反应发生率均较低,具有较高临床推荐价值。
Objective:To study the effect of ticagrelor and clopidogrel on platelet aggregation rate in acute myocardial infarction patients with percutaneous coronary intervention(PCI).Methods:One hundred and two acute myocardial infarction patients with PCI in the hospital from May 2017 to May 2018 were divided into control group and observation group according to random number table,with 51 cases in each group.The patients in control group were treated with clopidogrel(75 mg Qd,orally for 12 months),and the patients in observation group were treated with ticagrelor(90 mg Bid,orally for 12 months).The stroke volume(SV),left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD),left ventricular end systolic volume(LVESV)were detected by noninvasive hemodynamic analyzer and compared between the two groups before treatment and after treatment for 12 months.The platelet aggregation rate was detected by automatic blood cell analyzer and compared between the two groups before treatment and after treatment for 12 months.The major adverse cardiovascular events(MACE)and adverse drug reactions in two groups were recorded and compared during 12 months of treatment.Results:Compared with before treatment,SV and LVEF levels of the two groups were significantly increased(P<0.05),especially in the observation group(P<0.05);LVEDd and LVESV water in the treatment groups were significantly decreased(P<0.05),especially in the observation group(P<0.05);compared with before treatment,the platelet aggregation rate of each treatment group was significantly decreased(P<0.05),especially in the observation group(P<0.05)The incidence of mace events and the total incidence of adverse reactions in the observation group were lower than those in the control group(P<0.05).Conclusion:Ticagrelor can improve cardiac function and inhibit platelet aggregation in patients with acute myocardial infarction after coronary intervention,and the incidence of mace events and adverse drug reactions is low,which has high clinical recommendation value.
作者
王宏娟
Wang Hong-juan(Department of Cardiology,The First Affiliated Hospital of Nanyang Medical College,Nanyang 473000,Henan,China)
出处
《四川生理科学杂志》
2020年第4期406-409,405,共5页
Sichuan Journal of Physiological Sciences
关键词
急性心肌梗死
冠脉介入术
替格瑞洛
氯吡格雷
血小板聚集率
Acute myocardial infarction
Percutaneous coronary intervention
Ticagrelor
Clopidogrel
Platelet aggregation rate
