氯吡格雷联合替格瑞洛溶栓对老年STEMI行PCI术后患者心功能、心肌坏死标志物含量及血清炎症因子水平的影响

Effects of clopidogrel combined with ticagrelor thrombolysis on cardiac function,myocardial necrosis markers and levels of serum inflammatory factor in elderly STEMI patients undergoing PCI

目的:探讨氯吡格雷联合替格瑞洛溶栓对老年急性ST段抬高型心肌梗死(STEMI)行经皮冠状动脉介入(PCI)术后的效果。方法:选取老年STEMI行PCI术后患者125例,采用随机数字表法分组。对照组62例给予氯吡格雷溶栓治疗,观察组63例给予氯吡格雷联合替格瑞洛溶栓治疗,对比两组患者心功能:左室射血分数(LVEF)、左室舒张末期内径(LVEDD);心肌坏死标志物含量:肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白T(cTnT)、心肌肌钙蛋白I(cTnI);血清炎症因子水平:血清中C反应蛋白(CRP)、白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平。结果:治疗后观察组LVEF、LVEDD高于对照组,CK-MB、cTnT、cTnI、CRP、IL-6、TNF-α低于对照组,两组比较差异有统计学意义(P<0.05)。结论:氯吡格雷联合替格瑞洛溶栓治疗老年STEMI行PCI术后患者,可有效降低炎症因子水平和心肌坏死标志物含量,促进心功能加快恢复。

Objective:To analyze the efficacy of clopidogrel combined with ticagrelor thrombolysis in elderly patients with acute ST-segment elevation myocardial infarction(STEMI)undergoing percutaneous coronary intervention(PCI).Methods:A total of 125 elderly STEMI patients undergoing PCI were randomized into the control group and observation group.62 patients in the control group were given clopidogrel thrombolytic therapy,while another 63 patients in the observation group were given clopidogrel combined with ticagrelor thrombolytic therapy.The cardiac functions of the two groups,including left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD);myocardial necrosis marker content:creatine kinase isoenzyme(CK-MB),cardiac troponin T(cTnT),cardiac troponin I(cTnI);serum inflammatory factor level:serum C-reactive protein(CRP),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)levels,were compared.Results:After treatment,LVEF and LVEDD in the observation group were higher than those in the control group,and CK-MB,cTnT,cTnI,CRP,IL-6,and TNF-αwere lower than those in the control group,which were of statistical significances(P<0.05).Conclusion:Clopidogrel combined with ticagrelor thrombolysis can effectively reduce the levels of inflammatory factors and myocardial necrosis markers in elderly STEMI patients undergoing PCI,and accelerate the recovery of cardiac function.