替格瑞洛在急性ST段抬高型心肌梗死患者急诊PCI术中的应用观察

Application of ticagrelor in emergency PCI for patients with acute STEMI

目的了解替格瑞洛在急性ST段抬高型心肌梗死(STEMI)患者急性经皮冠状动脉介入术(PCI)术中的应用效果。方法80例急性STEMI患者随机分为观察组和对照组,每组40例。对照组在急诊PCI术前和术后给予氯吡格雷,观察组则给予替格瑞洛。对比两组的心外膜大血管血流灌注程度、心肌微循环指标、N-末端B型利钠肽前体(NTproBNP)浓度、左心室射血分数(LVEF)和不良心血管事件。结果与对照组相比,观察组的ST段回落程度较明显,磷酸肌酸同工酶峰值时间较早,磷酸肌酸同工酶峰值较低(P<0.01或0.05)。术后3个月,与对照组相比,观察组的LVEF水平较高,NT-proBNP的质量浓度和3个月内不良心血管事件总发生率较低(P<0.01或0.05)。结论在急诊STEMI患者PCI术前及术后使用替格瑞洛可明显改善心肌微循环,提高LVEF百分比,降低NT-proBNP浓度和不良心血管事件总发生率。

Objective To investigate the application value of ticagrelor in emergency PCI for patients with acute ST elevation myocardial infarction(STEMI).Methods A total of 80 patients with acute STEMI were randomized divided into the Observation Group and Control Group,40 cases in each group.The Control Group was given clopidogrel before and after emergency PCI while the Observation Group was given ticagrelor.The two groups were compared in terms of the degree of epicardial arterial perfusion,myocardial microcirculation index,NT-proBNP concentration,LVEF and adverse cardiovascular events.Results Compared with the Control Group,the Observation Group had a more significant ST-segment reduction,earlier peak time of creatine phosphate isozyme and lower peak value of creatine phosphate isozyme(P<0.01 or 0.05).Three months after the operation,compared with the Control Group,the Observation Group had a higher LVEF level,lower NTproBNP concentration and a lower incidence of major adverse cardiovascular events(P<0.01 or 0.05).Conclusion The application of ticagrelor before and after emergency PCI in patients with STEMI can significantly improve myocardial microcirculation,increase the percentage of LVEF,decrease the concentration of NT-proBNP and reduce the total incidence of adverse cardiovascular events.