氢氯吡格雷与替格瑞洛在急性ST段抬高型心肌梗死合并2型糖尿病患者经皮冠状动脉介入治疗中的效果观察

Efficacy of hydroclopidogrel and ticagrelor in PCI in patients with acute ST-segment elevation myocardial infarction and type 2 diabetes mellitus

目的:研究氢氯吡格雷与替格瑞洛在急性ST段抬高型心肌梗死合并2型糖尿病患者经皮冠状动脉介入术(PCI)治疗中的效果。方法:纳入98例急性ST段抬高型心肌梗死合并2型糖尿病患者展开研究,按照随机数字表法分为两组,对照组49例应用氢氯吡格雷治疗,观察组49例予以替格瑞洛治疗。将两组的TIMI分级情况、血小板功能、血清炎性因子水平、肱动脉内皮依赖性舒张功能(FMD)、血清内皮素-1(ET-1)、组织型纤溶酶原激活物水平(tPA)、心功能指标、心血管不良事件发生情况进行比对。结果:观察组患者的冠脉再通率高于对照组,治疗后的血小板反应单位(PRU)、血小板计数(MAR)以及血清炎性因子水平低于对照组,差异具有统计学意义(P<0.05);观察组患者治疗后的FMD、tPA以及左室射血分数(LVEF)高于对照组,ET-1水平以及左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)低于对照组,心血管不良事件发生率低于对照组,差异具有统计学意义(P<0.05)。结论:在急性ST段抬高型心肌梗死合并2型糖尿病患者PCI治疗中应用替格瑞洛的有效性和安全性高于氢氯吡格雷,更有利于改善心肌灌注、血管内皮功能以及心功能,可降低炎症血清炎性因子水平和血小板聚集率,减少心血管不良事件的发生。

Objective:To investigate the efficacy of hydroclopidogrel and ticagrelor in PCI in patients with acute ST-segment elevation myocardial infarction and type 2 diabetes.Methods:A total of 98 patients with acute ST-elevation myocardial infarction and type 2 diabetes were selected and divided into two groups according to the random number table method.49 patients in the control group were treated with hydroclopidogrel,and 49 patients in the observation group were treated with ticagrelor.TIMI grading,platelet function,levels of serum inflammatory factors,brachial flow mediated dilatation(FMD),serum endotherin-1(ET-1),tissue plasminogen activator(tPA)level,cardiac function indicators,and cardiovascular adverse events were compared between the two groups.Results:The rate of coronary recanulation in the observation group was higher than that of the control group,and the levels of PRU,MAR and levels of serum inflammatory factors after treatment were lower than those of the control group,with statistically significant differences(P<0.05).FMD,tPA and LVEF in the observation group after treatment were higher than those in the control group,ET-1 level,LVEDD,LVESD and the incidence of cardiovascular adverse events were lower than those in the control group,with statistically significant differences(P<0.05).Conclusion:The efficacy and safety of ticagrelor in PCI treatment for patients with acute ST-segment elevation myocardial infarction and type 2 diabetes are higher than hydroclopidogrel,and it is more conducive to improving myocardial perfusion,vascular endothelial function and cardiac function,Can reduce serum inflammatory factor levels and platelet aggregation rate,reduce the occurrence of cardiovascular adverse events.