替格瑞洛联合阿司匹林在经皮冠状动脉介入术后急性冠脉综合征患者中的应用效果

Application effect of tigrelol combined with aspirin for patients with acute coronary syndrome after percutaneous coronary intervention

目的 观察替格瑞洛联合阿司匹林在经皮冠状动脉介入术(PCI)后急性冠脉综合征(ACS)患者中的应用效果。方法 选取2019-2020年于乐平市人民医院行PCI的64例ACS患者作为研究对象,采用随机数字表法分为参照组和研究组,各32例。患者入院后均接受常规药物治疗,其中参照组采用氯吡格雷联合阿司匹林治疗,研究组采用替格瑞洛联合阿司匹林治疗,2组均持续治疗1个月。比较2组手术前后QT离散度,术前、术后24 h、术后1个月炎性因子[超敏C反应蛋白(hs-CRP)、肿瘤坏死因子α(TNF-α)及白介素(IL)-4]水平、血小板聚集功能指标[血小板聚集率(MPAR)、P2Y12反应单位(PRU)],术后6个月不良心血管事件发生率。结果 术后,2组QT离散度低于术前,且研究组低于参照组(P<0.01)。研究组术后24 h、1个月hs-CRP、TNF-α水平及术后1个月IL-4水平低于参照组(P<0.05)。2组术后24 h、1个月MPAR、PRU低于术前,术后1个月MPAR、PRU低于术后24 h,且研究组术后24 h、1个月低于参照组(P<0.05)。研究组不良心血管事件总发生率为6.25%,低于参照组的25.00%(χ^(2)=4.200,P=0.040)。结论 ACS患者PCI后采用替格瑞洛联合阿司匹林可获得较好的抗血小板效果,可有效减轻炎性反应,改善血小板聚集功能,降低不良心血管事件发生率。

Objective To investigate the application effect of tigrelol combined with aspirin for patients with acute coronary syndrome(ACS) after percutaneous coronary intervention(PCI).Methods A total of 64 patients with ACS who underwent PCI in Leping People’s Hospital from 2019 to 2020,and they were divided into reference group and study group according to random number table method,32 cases in each group.All patients were received conventional drug therapy,patients in the reference group were received clopidogrel combined with aspirin antiplatelet therapy,and patients in the study group were treated with tigritol combined with aspirin,both groups were treated for 1 month.QT dispersion before and after operation,inflammatory factors(hs-CRP,TNF-α,IL-4) levels and platelet aggregation function indexes(MPAR,PRU) before operation and 24 h,1 month after operation,and the incidence of adverse cardiovascular events 6 months after operation were compared between the two groups.Results After operation,QT dispersion in the two groups was lower than that before operation,and which in study group was lower than that in reference group (P<0.01).Levels of hs-CRP,TNF-αat 24 h,1 month after operation and IL-4 level at 1 month after operation in study group were lower than those in reference group(P<0.05).MPAR、PRU at 24 h,1 month in the two groups were lower than those before operation,MPAR,PRU at 1 month after operation were lower than those at 24 h after operation,and those at 24 h,1 months after operation in study group were lower than reference group(P<0.05).Incidence of adverse cardiovascular events in study group was 6.25%,lower than25.00%in reference group(χ^(2)=4.200,P=0.040).Conclusion Patients with ACS can achieve significant therapeutic effect after antiplatelet treatment with tigrelol combined with aspirin after PCI,which can improve inflammatory reaction,relieve myocardial ischemia and hypoxia,and then reduce the incidence of adverse cardiovascular events.