术前应用负荷量替格瑞洛对STEMI患者急诊PCI术中心肌灌注的影响

Influence by preoperative application of loading dose ticagrelor on myocardial perfusion during emergent PCI operation in STEMI patients

目的观察术前应用负荷量替格瑞洛对急性ST段抬高性心肌梗死(STEMI)患者急诊经皮冠状动脉介入治疗(PCI)术中心肌灌注的影响。方法 150例STEMI患者,随机分为对照组及观察组,各75例。对照组PCI术前给予氯吡格雷,观察组给予负荷量替格瑞洛。观察患者心肌灌注情况。结果观察组心肌梗死溶栓试验(TIMI)Ⅲ级、心肌灌注分级(TMPG)Ⅲ级占比(94.67%、89.33%)高于对照组(78.67%、72.00%),且无复流或慢血流发生率(6.67%)低于对照组(24.00%),差异有统计学意义(P<0.05);观察组校正的TIMI帧数(CTFC)为(19.98±4.97)帧,低于对照组的(31.89±3.97)帧,差异有统计学意义(t=16.215,P<0.05)。结论对STEMI患者行PCI术前给予负荷量替格瑞洛,可有效促进患者心肌灌注情况改善。

Objective To observe influence by preoperative application of loading dose ticagrelor on myocardial perfusion during emergent percutaneous coronary intervention（PCI） operation in acute ST-segment elevation myocardial infarction（STEMI） patients. Methods A total of 150 STEMI patients were randomly divided into control group and observation group, with 75 cases in each group. The control group received clopidogrel before PCI, and the observation group received loading dose ticagrelor instead. Myocardial perfusion condition was observed in patients. Results The observation group had higher proportion of thrombolysis in myocardial infarction（TIMI） grade Ⅲ and TIMI myocardial perfusion grade（TMPG） Ⅲ（94.67%, 89.33%） than the control group（78.67%, 72.00%）, and it had no reflow case. The observation group also had lower incidence of slow flow（6.67%） than the control group（24.00%）, and their difference had statistical significance（P〈0.05）. The observation group had corrected TIMI frame count（CTFC） as（19.98±4.97） frames, which was lower than（31.89±3.97） frames in the control group, and the difference had statistical significance（t=16.215, P〈0.05）. Conclusion Implement of loading dose ticagrelor on myocardial perfusion before emergent PCI operation in STEMI patients can effectively accelerate improvement of myocardial perfusion in patients.