替格瑞洛联合吲哚布芬对急性ST抬高型心肌梗死患者临床疗效及预后的影响

Effect of ticagrelor combined with indobufen on clinical efficacy and prognosis of patients with acute ST-segment elevation myocardial infarction

目的观察替格瑞洛联合吲哚布芬对急性ST段抬高型心肌梗死(STEMI)患者临床疗效及预后的影响。方法选取2019年9月至2020年6月重庆市璧山区人民医院心血管内科收治的STEMI患者106例作为研究对象,采用随机数字表法分为对照组(替格瑞洛联合阿司匹林)和观察组(替格瑞洛联合吲哚布芬),每组53例。观察两组患者冠状动脉血流灌注、血小板功能、心功能、主要不良心血管事件(MACE)及不良反应发生率等。结果与对照组比较,观察组患者经皮冠状动脉介入治疗后心肌梗死溶栓治疗和心肌灌注分级血流3级发生率明显增加,服药1周后血小板聚集率、P2Y12反应单位均明显降低,服药后6个月左心室射血分数明显升高,左心室舒张末期内径、脑钠肽明显降低,差异均有统计学意义(P<0.05)。与对照组比较,观察组住院期间、出院6个月内MACE发生率明显降低,差异均有统计学意义(P<0.05);观察组患者次要出血、轻微出血事件发生率稍低于对照组,但差异无统计学意义(P>0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论替格瑞洛联合吲哚布芬可明显降低STEMI患者血小板聚集率,改善冠状动脉血流,提高患者心功能水平,改善患者预后。

Objective To observe the effect of ticagrelor combined with indobufen on the clinical efficacy and prognosis of the patients with acute ST-segment elevation myocardial infarction(STEMI).Methods A total of 106 cases of STEMI treated in the cardiology department of this hospital from September 2019 to June 2020 were selected as the research subjects and divided into the control group(ticagrelor+aspirin)and observation group(ticagrelor+indobufen)according to the random number table method,53 cases in each group.The coronary blood perfusion,platelet function,heart function,major adverse cardiovascular events(MACE)and incidence rate of adverse reactions were observed in the two groups.Results Compared with the control group,the level 3 ratio of TIMI and TMPG blood flow after PCI in the observation group was increased significantly,the platelet aggregation rate and P2Y12 reaction unit after 1-week medication in the observation group were significantly reduced,the left ventricular ejection fraction(LVEF)after 6-month medication in the observation group was significantly increased,while the left ventricular end diastolic diameter(LVEDD)and brain natriuretic peptide(BNP)were significantly decreased,the incidence rate of MACE during hospitalization and within 6 months of discharge was significantly decreased,and the differences were statistically significant(P<0.05).The incidence rate of minor bleeding and mild bleeding events in the observation group was slightly lower than that in the control group,but the difference was not statistically significant(P>0.05).There was no statistically significant difference in the incidence rate of adverse reactions between the two groups(P>0.05).Conclusion Ticagrelor combined with indobufen can significantly reduce the platelet aggregation rate,improve the coronary blood flow,increase the cardiac function level and improve the prognosis of the patients with STEMI.