替格瑞洛联合阿司匹林对急性ST段抬高型心肌梗死患者心肌酶谱及炎性指标的影响

Effects of ticagrelor combined with aspirin on myocardial enzyme profiles and inflammatory indexes in patients with acute ST-segment elevation myocardial infarction

目的探讨替格瑞洛联合阿司匹林对急性ST段抬高型心肌梗死(STEMI)患者心肌酶谱及炎性指标的影响。方法选取2018年8月至2019年8月本院收治的120例STEMI患者作为研究对象,根据治疗方法的不同分为对照组和观察组,每组60例。对照组采用阿司匹林+氯吡格雷治疗,观察组采用替格瑞洛+阿司匹林治疗。比较两组患者治疗后7 d心肌酶谱[肌酸磷酸激酶(CK)、心肌激酶同工酶(CK-MB)、谷草转氨酶(AST)、乳酸脱氢酶(LDH)]、炎性指标[C反应蛋白(CRP)、肿瘤坏死因子-α(INF-α)、白细胞介素-6(IL-6)]、住院时间、并发症发生率及治疗后1、3、6个月常规指标[左心室射血分数(EF)、ST段回落(STR)及血小板平均水平]。结果治疗后7 d,观察组CK、CK-MB、AST、LDH、CRP、INF-α、IL-6水平均低于对照组,且住院时间短于对照组,差异有统计学意义(P<0.05);治疗后1、3、6个月,观察组EF、STR水平均高于对照组,差异有统计学意义(P<0.05);两组并发症发生率比较差异无统计学意义。结论STEMI患者采用替格瑞洛治疗效果确切,可降低心肌酶与炎症水平,保护患者的心功能,促进心肌有效再灌注,且可缩短患者的住院时间,安全性高,值得临床推广应用。

Objective To investigate the effects of ticagrelor combined with aspirin on myocardial enzyme profiles and inflammatory indexes in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods 120 cases of STEMI patients admitted to our hospital from Au-gust 2018 to August 2019 were selected as the study subjects.According to different treatment methods,they were divided into control group and ob-servation group,with 60 cases in each group.The control group was treated with aspirin+clopidogrel,and the observation group was treated with ti-cagrelo+aspirin.Myocardial enzyme profiles[CK,CK-MB,AST,LDH]7 days after treatment,inflammatory indexes[CRP,INF-α,IL-6],the total length of hospital stay and the incidence of complications,routine indexes[left ventricular ejection fraction(EF),ST segment drop(STR)and mean platelet level]at 1,3 and 6 months after treatment were compared between the two groups.Results 7 days after treatment,the levels of CK,CK-MB,AST,LDH,CRP,INF-αand IL-6 in the observation group were lower than those in the control group,and the hospital stay was shorter than that in the control group,the difference was statistically significant(P<0.05).At 1,3 and 6 months after treatment,EF and STR levels in observation group were higher than those in control group,the difference was statistically significant(P<0.05).There was no significant difference in the inci-dence of complications between the two groups.Conclusion The treatment effect of ticagrelor for STEMI patients is definite,which can reduce the level of myocardial enzyme and inflammation,protect the cardiac function of patients,promote effective myocardial reperfusion,shorten the hospital stay of patients,the safety is high,and it is worthy of clinical promotion and application.