替格瑞洛与阿司匹林双联抗血小板方案对STEMI行PCI术后患者血管内皮细胞功能及心功能的影响

Effects of dual antiplatelet therapy with ticagrelor and aspirinon on vascular endothelial cell functions and cardiac functions in patients with STEMI after PCI

目的:探讨替格瑞洛、阿司匹林双联抗血小板方案对急性ST段抬高型心肌梗死(STEMI)行经皮冠状动脉介入(PCI)术后患者血管内皮细胞功能及心功能的影响。方法:选取125例STEMI行PCI术后患者,按随机数字法分为对照组62例(氯吡格雷治疗)和观察组63例(替格瑞洛治疗),对比治疗效果。结果:观察组术后7 d左室射血分数(LVEF)、二尖瓣舒张早、晚期最大血流速度(E/A值)高于对照组,左室收缩末期内径(LVESd)、舒张末期内径(LVEDd)小于对照组(P<0.05);术后1个月末观察组与对照组的静息血管直径、静息血流速度、FMD、NMD水平差异均无统计学意义(P>0.05),在术后6个月末静息血管直径观察组小于对照组,静息血流速度、血管内皮依赖性舒张功能(FMD)、非依赖性血管内皮舒张功能(NMD)水平观察组均高于对照组(P<0.05);两组不良反应发生情况差异无统计学意义(P>0.05)。结论:替格瑞洛、阿司匹林双联抗血小板方案应用于STEMI行PCI术后患者中,通过改善其内皮细胞功能,进而改善心功能,且不增加不良反应。

Objective:To investigate the effect of dual antiplatelet therapy with ticagrelor and aspirin on vascular endothelial cell functions and cardiac functions in patients with acute ST-segment elevation myocardial infarction(STEMI)after undergoing percutaneous coronary intervention(PCI).Methods:125 patients with STEMI after undergoing PCI were selected and randomly divided into the control group(62 cases,clopidogrel treatment)and the observation group(63 cases,ticagrelor treatment),with the therapeutic effects compared.Results:7 days after operation,the left ventricular ejection fraction(LVEF),the maximum blood flow velocity(E/A value)of early and late diastole of the mitral valve in the observation group were higher than those of the control group.The Left ventricular end systolic diameter(LVESd)and the Left ventricular end diastolic diameter(LVEDd)were smaller than those of the control group(P<0.05);there was no significant difference in the resting vessel diameter,resting blood flow velocity,endothelium-dependent dilation function(FMD)and non-dependent vascular endothelial dilation function(NMD)levels between the observation group and the control group at the end of the 1st month after surgery(P>0.05);At the end of the 6th month after surgery,the resting blood vessel diameter in the observation group was smaller than that in the control group,and the resting blood flow velocity,FMD,and NMD levels in the observation group were higher than those of the control group group(P<0.05);there was no significant difference in the occurrence of adverse reactions between the two groups(P>0.05).Conclusion:Dual antiplatelet therapy with ticagrelor and aspirin is very effective in patients with STEMI after PCI.It can improve the cardiact function without increasing adverse reactions by improving the function of endothelial cells.