氯吡格雷和替格瑞洛分别联合溶栓治疗STEMI患者的效果及对心功能和血液相关指标情况的影响

The Effects of Clopidogrel and Ticagrelor Combined with Thrombolytic Therapy on Patients with STEMI and the Influence on Cardiac Function and Blood-related Indexes

目的:探讨氯吡格雷和替格瑞洛分别联合溶栓治疗对ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者的效果及对心功能和血液相关指标情况的影响。方法:选取2018年7月-2019年7月于本院治疗的STEMI患者98例。采用随机数字表法分为Ti组和Cl组,各49例。Ti组予以替格瑞洛+阿司匹林治疗,Cl组予以氯吡格雷+阿司匹林治疗。比较两组临床疗效、心功能情况、血液相关指标及不良反应发生情况。结果:Ti组的临床总有效率为93.88%,显著高于Cl组的77.55%,差异均有统计学意义(P<0.05)。治疗后,两组LVEDD、LVEF均优于治疗前,且Ti组上述指标均优于Cl组,差异均有统计学意义(P<0.05)。治疗后,两组CRP、IL-6、PAR、PRU水平均降低,且Ti组CRP、IL-6、PAR、PRU水平均显著低于Cl组,差异均有统计学意义(P<0.05)。Ti组的不良反应发生率为10.20%,与Cl组12.24%比较,差异无统计学意义(P>0.05)。结论:替格瑞洛联合溶栓治疗较氯吡格雷联合溶栓治疗STEMI效果更显著,可有效恢复患者心功能,改善血小板凝聚情况,减轻炎症反应,且未增加不良反应的发生。

Objective:To investigate the effect of Clopidogrel and Ticagrelor combined with thrombolytic therapy on patients with ST-segment elevation myocardial infarction(STEMI)and the influence on cardiac function and blood-related indexes.Method:A total of 98 STEMI patients treated in our hospital from July 2018 to July 2019 were selected.Ti group and Cl group were divided by random number table method,49 cases in each group.Ti group was treated with Ticagrelor+Aspirin,the Cl group was treated with Clopidogrel+Aspirin.The clinical efficacy,cardiac function,blood-related indexes and adverse reactions of the two groups were compared.Result:The total clinical effective rate of Ti group was 93.88%,significantly higher than 77.55%of Cl group,the differences were statistically significant(P<0.05).After treatment,LVEDD and LVEF in both groups were better than those before treatment,and the above indicators in Ti group were better than those in Cl group,with statistically significant differences(P<0.05).After treatment,the levels of CRP,IL-6,PAR and PRU in both groups were reduced,and the levels of CRP,IL-6,PAR and PRU in the Ti group were significantly lower than those in the Cl group,with statistically significant differences(P<0.05).The incidence of adverse reactions in Ti group was 10.20%,which was not significantly different from 12.24%in Cl group(P>0.05).Conclusion:Ticagrelor combined with Thrombolytic therapy is more effective than Clopidogrel combined with Thrombolytic therapy in STEMI,which can effectively restore cardiac function,improve platelet aggregation,reduce inflammatory reaction,and does not increase the incidence of adverse reactions.