替格瑞洛联合阿司匹林治疗老年急性冠状动脉综合征的效果及对血清cTnT、BNP、CRP及D-D水平的影响

Efficacy of Ticagrelor Combined with Spirin in the Treatment of Elderly Patients with Acute Coronary Syndrome and Its Effect on the Serum cTnT, BNP, CRP and D-D Levels

目的:探讨替格瑞洛联合阿司匹林治疗老年急性冠状动脉综合征的效果及对血清肌钙蛋白-T(Cardiac Troponin T,cTnT)、C反应蛋白(C-reactionprotein,CRP)、脑钠素(Brain natriuretic peptide,BNP)及D-二聚体(D-Dimer,D-D)水平的影响。方法:选取2016年1月~2019年1月我院收治的急性冠状动脉综合征老年患者60例,采用随机数字表法将患者分为两组,每组30例。两组患者均行经皮冠状动脉介入(Percutaneous coronary intervention,PCI)治疗,对照组术后给予阿司匹林和氯吡格雷,观察组给予阿司匹林和替格瑞洛。比较两组患者的临床治疗效果、心功能相关指标,治疗前后血清cTnT、BNP、CRP及D-D水平的变化情况及出血事件的发生率。结果:治疗后,观察组治疗总有效率显著高于对照组(93.33%vs. 70%,P <0.05);两组左室收缩末期内径(Left ventricular end systolic diameter,LVESD)、左室舒张末期内径(left ventricular end-diastolic diameter,LVEDD)、左心房内径(Left atrial diastolic diameter,LADD)、血清cTnT、BNP、CRP及D-D水平均较治疗前显著降低(P<0.05),而左室射血分数(left ventricular ejection fraction,LVEF)较治疗前明显升高(P <0.05),且观察组LVESD、LVEDD、LADD均明显低于对照组(P <0.05),而LVEF显著高于对照组(P <0.05)。此外,观察组出血事件发生率显著低于对照组(P <0.05)。结论:与阿司匹林和氯吡格雷相比,替格瑞洛联合阿司匹林可更有效改善老年急性冠状动脉综合征患者的心功能,且出血事件的发生率更低,可能与其显著降低血清cTnT、BNP、CRP及D-D水平有关。

Objective: To investigate the effect of ticagrelor combined with aspirin in the treatment of acute coronary syndrome in the elderly and on serum troponin-T(Catanic Troponin T, cTnT), C-reaction protein(CRP), brain natriuretic peptide(Brain natriuretic peptide, BNP) and D-dimer(D-D) levels. Methods: 60 cases of elderly patients with acute coronary syndrome admitted to our hospital from January 2016 to January 2019 were selected. The patients were divided into two groups using the random number table method, 30 cases in each group. Patients in both groups were treated with percutaneous coronary intervention(Percutaneous coronary intervention,PCI), while aspirin and clopidogrel were given postoperatively in the control group and aspirin and ticagrelor in the observation group.The clinical therapeutic effect, indicators related to cardiac function, serum cTnT, BNP, CRP and D-D levels before and after treatment and the incidence of bleeding events were compared between the two groups. Results: After treatment, the total effective rate in the observation group was significantly higher than that of the control group(93.33 % vs. 70 %, P <0.05). After treatment, left ventricular end systolic diameter(LVESD) and left ventricular end diastolic diameter(left) Ventricular end-diastolic diameter(LVEDD), left atrial diastolic diameter(LADD), serum cTnT, BNP, CRP, and D-D levels were significantly lower than before treatment(P <0.05), while left ventricular ejection fraction(left) The ventricular ejection fraction(LVEF) was significantly higher than that before treatment(P <0.05),and the LVESD, LVEDD, and LADD in the observation group were significantly lower than those in the control group(P <0.05), while the LVEF was significantly higher than the control group(P <0.05). The incidence of bleeding events was significantly lower than that in the control group(P <0.05). Conclusion: Compared with aspirin and clopidogrel, ticagrelor combined with aspirin is more effective in improving cardiac function in elderly patients with acute coronary syndrome, and the incidence of bleeding events is lower, which may significantly reduce serum cTnT, BNP, CRP and DD level related.