替格瑞洛联合低分子肝素治疗急性冠脉综合征临床观察

Tegrilol Combined with Low Molecular Weight Heparin for Acute Coronary Syndrome

目的探讨替格瑞洛联合低分子肝素治疗急性冠脉综合征(ACS)的临床疗效及对患者血清基质金属蛋白酶-9(MMP-9)和髓过氧化物酶(MPO)水平的影响。方法选取医院2018年1月至2019年7月收治的ACS患者92例,按奇偶分配原则分为观察组和对照组,各46例。两组患者均予ACS常规治疗,并皮下注射低分子肝素钙注射液,观察组患者加服替格瑞洛片。结果观察组总有效率为89.13%,显著高于对照组的71.74%(P<0.05);与治疗前比较,两组患者治疗后的左室射血分数(LVEF)显著升高,左室收缩末内径(LVESd)、左室舒张末内径(LVEDd)均显著缩短,D-二聚体(D-D)、纤维蛋白原(FIB)、MMP-9及MPO水平均显著降低,活化部分凝血活酶时间(APTT)显著延长,且观察组患者上述指标改善程度均显著优于对照组(P<0.05);观察组与对照组不良反应发生率相当(15.22%比8.70%,χ2=0.929,P>0.05)。结论替格瑞洛联合低分子肝素治疗ACS,可改善患者的心功能和凝血功能指标水平,降低MMP-9和MPO等炎性因子水平。

Objective To investigate the clinical efficacy of tegrilol combined with low molecular weight heparin on serum levels of matrix metalloproteinase-9(MMP-9)and myeloperoxidase(MPO)in patients with acute coronary syndrome(ACS).Methods A total of 92 patients with ACS admitted to the hospital from January 2018 to July 2019 were selected and divided into the observation group and control group according to the principle of random distribution,46 cases in each group.The control group was treated with low molecular weight heparin,while the observation group was added with tegrilol.Results The total effective rate of the observation group was 89.13%,which was significantly higher than 71.74%of the control group(P<0.05).Compared with before treatment,the left ventricular ejection fraction(LVEF)of the two groups was significantly increased.The left ventricular end systolic diameter(LVESd)and left ventricular end diastolic diameter(LVEDd)were significantly shortened,and D-dimer(D-D),fibrinogen(FIB),MMP-9 and MPO levels were significantly reduced,activated partial thromboplastin time(APTT)was significantly prolonged,and the improvements of the above indicators in the observation group were significantly better than those of the control group(P<0.05).The incidences of adverse reactions in the observation group and control group were equivalent(15.22%vs.8.70%,χ~2=0.929,P>0.05).Conclusion Tegrilol combined with low molecular weight heparin is effective in the treatment of ACS.It can improve the cardiac function and coagulation function of patients,reduce the levels of inflammatory factors such as MMP-9 and MPO.