急诊PCI术前服用替格瑞洛对急性心肌梗死患者预后的影响

Effect of ticagrelor administration before emergency PCI on prognosis of patients with acute myocardial infarction

目的分析急诊经皮冠状动脉介入术(PCI)前服用替格瑞洛对急性心肌梗死患者预后的影响。方法选取200例急性心肌梗死患者作为研究对象,以治疗方案的不同分为常规组(100例,术前常规治疗)和观察组(100例,术前常规治疗+替格瑞洛)。比较两组患者的治疗效果。结果治疗后,观察组的血流储备分数(FFR)、平均血流速度(Vm)明显高于常规组,微循环抵抗指数(IMR)、阻力指数(RI)明显低于常规组(P<0.05)。治疗后,观察组的N末端脑钠肽前体(NT-proBNP)、肿瘤坏死因子-α(TNF-α)、天冬氨酸转氨酶(AST)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I(cTnI)水平均明显低于常规组(P<0.05)。治疗后,观察组的左心室射血分数(LVEF)明显高于常规组,左室收缩末期内径(LVESD)、左心室收缩期末容量(LVESV)、左室舒张期末容量(LVEDV)明显低于常规组(P<0.05)。观察组的再发心绞痛、靶血管重建、心源性死亡及支架内血栓形成率均明显低于常规组,差异具有统计学意义(P<0.05)。结论急性心肌梗死患者PCI术前服用替格瑞洛的效果显著,可改善患者冠动脉微循环,降低不良心血管事件发生率,进而改善预后情况。

Objective To analyze the effect of ticagrelor administration before emergency percutaneous coronary intervention(PCI)on prognosis of patients with acute myocardial infarction.Methods A total of 200 patients with acute myocardial infarction were selected as the research objects and divided into routine group(100 cases,preoperative conventional treatment)and observation group(100 cases,preoperative conventional treatment+ticagrelor)according to different treatment schemes.The therapeutic effects of the two groups were compared.Results After treatment,the fractional flow reserve(FFR)and mean velocity(Vm)in the observation group were significantly higher than those in the routine group,while the index of microcirculation resistance(IMR)and resistive index(RI)in the observation group were significantly lower than those in the routine group(P<0.05).After treatment,the levels of N-terminal pro-brain natriuretic peptide(NT-proBNP),tumor necrosis factor-α(TNF-α),aspartate transaminase(AST),creatine kinase(CK),creatine kinase MB(CK-MB)and cardiac troponin I(cTnI)in the observation group were significantly lower than those in the routine group(P<0.05).After treatment,the left ventricular ejection fraction(LVEF)in the observation group was significantly higher than that in the routine group,while the left ventricular end systolic diameter(LVESD),left ventricular end systolic volume(LVESV)and left ventricular end diastolic volume(LVEDV)in the observation group were significantly lower than those in the routine group,and the differences were statistically significant(P<0.05).Conclusion Ticagrelor administration before PCI for patients with acute myocardial infarction has a significant effect,it can improve the coronary microcirculation,reduce the incidence of adverse cardiovascular events,and improve the prognosis.