摘要
目的分析替格瑞洛联合硝酸甘油治疗急性心肌梗死的临床效果。方法106例急性心肌梗死患者,按照治疗方式的差异性分为单一用药组和联合用药组,每组53例。单一用药组患者使用硝酸甘油氯化钠注射液治疗,联合用药组患者在单一用药组基础上使用替格瑞洛治疗。比较两组患者临床疗效、不良反应发生情况以及心功能指标[左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)]、生活质量、心肌梗死面积、QRS评分、血清学指标[血管内皮细胞蛋白C受体(EPCR)、C反应蛋白(CRP)、白细胞介素-8(IL-8)]。结果联合用药组治疗总有效率98.11%高于单一用药组的83.02%,不良反应发生率5.66%低于单一用药组的22.64%,差异具有统计学意义(P<0.05)。干预后,联合用药组LVEF(55.29±5.07)%高于单一用药组的(47.52±4.15)%,LVEDD(52.15±2.14)mm、LVESD(40.25±3.25)mm均小于单一用药组的(59.36±2.28)、(46.26±3.11)mm,差异均具有统计学意义(P<0.05)。联合用药组总体健康、认知能力、情感职能、活力情况、精神健康、躯体疼痛、社会功能、生理职能评分分别为(80.25±5.25)、(83.26±5.28)、(82.25±4.15)、(83.26±2.58)、(85.25±2.64)、(86.39±2.58)、(89.33±2.57)、(90.36±2.58)分,均高于单一用药组的(70.44±5.17)、(64.15±5.16)、(71.28±3.28)、(68.26±3.55)、(63.29±5.29)、(66.39±4.17)、(69.63±4.18)、(66.39±2.39)分,差异均具有统计学意义(P<0.05)。干预后,联合用药组患者QRS评分(4.34±0.63)分、心肌梗死面积(12.66±2.58)%均低于单一用药组的(5.71±0.88)分、(17.63±3.25)%,差异均具有统计学意义(P<0.05)。干预后,联合用药组患者血清IL-8(36.28±11.27)pg/ml、CRP(3.69±0.58)mg/L、EPCR(5.71±1.82)pg/ml均低于单一用药组的(56.26±14.27)pg/ml、(5.69±1.27)mg/L、(8.24±2.67)pg/ml,差异均具有统计学意义(P<0.05)。结论针对急性心肌梗死患者,应用替格瑞洛联合硝酸甘油治疗效果显著,安全性高,能改善患者的心脏功能,降低血清炎性指标水平,提升生活质量,值得临床进一步推广和应用。
Objective To analyze the clinical effect of ticagrelor combined with nitroglycerin in the treatment of acute myocardial infarction.Methods A total of 106 patients with acute myocardial infarction were divided into single-drug group and combination-drug group according to the differences in treatment methods,with 53 cases in each group.Patients in the single-drug group were treated with nitroglycerin and sodium chloride injection,while patients in the combination-drug group were treated with ticagrelor on the basis of the singledrug group.Both groups were compared in terms of clinical efficacy,occurrence of adverse reactions,cardiac function indicators[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD)],quality of life,infarct size,QRS score,serological indicators[vascular endothelial protein C receptor(EPCR),C-reactive protein(CRP),interleukin-8(IL-8)].Results The total effective rate 98.11%of the combination-drug group was higher than 83.02%of the single-drug group,and the incidence of adverse reactions 5.66%was lower than(22.64%)of the single-drug group,and the differences were all statistically significant(P<0.05).After intervention,the LVEF(55.29±5.07)%of the combination-drug group was higher than(47.52±4.15)%of the single-drug group;the LVEDD(52.15±2.14)mm and LVESD(40.25±3.25)mm of the combination-drug group were less than(59.36±2.28)and(46.26±3.11)mm of the single-drug group;the differences were all statistically significant(P<0.05).The scores of overall health,cognitive ability,emotional function,vitality,mental health,physical pain,social function,and physiological function in the combination-drug group were(80.25±5.25),(83.26±5.28),(82.25±4.15),(83.26±2.58),(85.25±2.64),(86.39±2.58),(89.33±2.57),and(90.36±2.58)points,which were higher than(70.44±5.17),(64.15±5.16),(71.28±3.28),(68.26±3.55),(63.29±5.29),(66.39±4.17),(69.63±4.18),and(66.39±2.39)points in the single-drug group,and the differences were all statistically significant(P<0.05).After intervention,the QRS score in the combination-drug group was(4.34±0.63)points,and the infarct area was(12.66±2.58)%,which were lower than(5.71±0.88)points and(17.63±3.25)%in the single-drug group,and the differences were all statistically significant(P<0.05).After intervention,the serum IL-8(36.28±11.27)pg/ml,CRP(3.69±0.58)mg/L,EPCR(5.71±1.82)pg/ml,EPCR(5.71±1.82)pg/ml in the combination-drug group were lower than(56.26±14.27)pg/ml,(5.69±1.27)mg/L and(8.24±2.67)pg/ml in the single-drug group,and the differences were all statistically significant(P<0.05).Conclusion The use of ticagrelor combined with nitroglycerin is effective and safe for patients with acute myocardial infarction,which can improve the cardiac function of patients,reduce the serum inflammatory index and improve the quality of life,and is worthy of further clinical promotion and application.
作者
许钰琳
叶丹
韩磊
XU Yu-lin;YE Dan;HAN Lei(Beijing Aerospace General Hospital,Beijing 100076,China)
出处
《中国现代药物应用》
2022年第20期1-5,共5页
Chinese Journal of Modern Drug Application
关键词
替格瑞洛
硝酸甘油
急性心肌梗死
效果
分析
Ticagrelor
Nitroglycerin
Acute myocardial infarction
Effect
Analysis
