三联抗血小板治疗急性ST段抬高型心肌梗死患者的临床效果研究

Study on the Clinical Effect of Triple Antiplatelet in the Treatment of Patients with Acute ST-Segment Elevation Myocardial Infarction

目的 探讨三联抗血小板治疗急性ST段抬高型心肌梗死(STEMI)患者的临床效果。方法 选取2019年1月至2021年1月我院收治的75例急性STEMI患者,随机分为对照组(n=38)和观察组(n=37)。两组患者均行急诊PCI治疗,对照组在PCI术后采用阿司匹林联合氯吡格雷治疗,观察组在PCI术后采用阿司匹林、替格瑞洛、替罗非班治疗。比较两组患者的心肌酶水平、不良反应及主要心血管不良事件(MACE)发生率。结果 治疗后,观察组的肌钙蛋白、肌酸激酶、肌酸激酶同工酶水平低于对照组(P<0.05)。观察组不良反应发生率为16.2%,与对照组的10.5%比较差异无统计学意义(P<0.05)。观察组的MACE发生率为2.7%,低于对照组的21.1%(P<0.05)。结论 阿司匹林、替格瑞洛、替罗非班三联抗血小板可减轻急性STEMI患者的心肌损伤,降低MACE发生风险,且用药安全性良好。

Objective To explore the clinical effect of triple antiplatelet in the treatment of patients with acute ST-segment elevation myocardial infarction(STEMI).Methods 75 cases of patients with acute STEMI admitted to our hospital from January 2019 to January 2021 were selected and randomly divided into control group(n=38)and observation group(n=37).Both groups were treated with emergency PCI.The control group was treated with aspirin combined with clopidogrel after PCI,and the observation group was treated with aspirin,ticagrelor and tirofiban after PCI.The levels of myocardial enzymes,adverse reactions and incidence of major adverse cardiovascular events(MACE)were compared between two groups.Results After treatment,the levels of troponin,creatine kinase and creatine kinase isozymes in the observation group were lower than those in the control group(P<0.05).The incidence of adverse reactions in the observation group was 16.2%,had no statistical difference with 10.5%in the control group(P<0.05).The MACE incidence of the observation group was 2.7%,lower than 21.1%of the control group(P<0.05).Conclusions Aspirin,ticagrelor and tirofiban triple antiplatelet can reduce the myocardial injury and the risk of MACE in patients with acute STEMI,with good drug safety.