氯吡格雷与替格瑞洛早期静脉溶栓治疗对STEMI患者疗效观察

Observation of curative effect of early intravenous thrombolysis with clopidogrel and ticagrelor in patients with STEMI

目的 探究氯吡格雷与替格瑞洛早期静脉溶栓治疗对ST段抬高型心肌梗死(STEMI患者疗效。方法 选取2020年1月至2022年2月于颍上县人民医院接受治疗的78例STEMI患者为本次研究对象,随机数字表法分组,观察组及对照组(n=39)。常规方案联合氯吡格雷治疗对照组,常规方案联合替格瑞洛早期静脉溶栓治疗观察组。比较凝血功能、临床症状改善情况、心功能治疗效果。结果 治疗后30 d、60 d,凝血酶、凝血酶原及活化部分凝血酶时间(TT)、(PT)及(APTT)、D-二聚体(D-D)、血浆纤维蛋白原(FIB)水平,观察组及对照组均较治疗前提高,且观察组低于对照组,差异有统计学意义(P<0.05);观察组无复流现象低于对照组,PCI后2 hST段完全回落率高于对照组,观察组PCI后cTFC低于对照组,差异有统计学意义(P<0.05);治疗后30 d、60 d,左心室舒张末期内径(LVEDD)水平,观察组及对照组均较治疗前降低,且观察组低于对照组,左心室射血分数(LVEF)水平,观察组及对照组较治疗前提高,且观察组高于对照组,差异有统计学意义(P<0.05)。结论 替格瑞洛早期静脉溶栓治疗STEMI患者,可有效调节凝血功能,改善临床症状进而提升心功能,较氯吡格雷的疗效更佳。

Objective To investigate the efficacy of early intravenous thrombolysis with clopidogrel and ticagrelor in patients with ST-segment elevation myocardial infarction(STEMI). Methods A total of 78 STEMI patients who received treatment in Yingshang County People’s Hospital from January 2020 to February 2022 were selected as the subjects of this study and were randomly divided into the observation group and the control group(n=39). The conventional regimen combined with clopidogrel was used in the control group,and the conventional regimen combined with ticagrelor early intravenous thrombolysis in the observation group. The coagulation function,improvement of clinical symptoms,treatment effect of cardiac function and adverse cardiovascular events were compared. Results The levels of thrombin,prothrombin,activated partial thrombin time(TT),(Prothrombin time,PT)and(activated partial thromboplastin time,APTT),D-dimer(D-dimer)at 30 and 60 days after treatment dimer,D-D)and plasma fibrinogen(FIB)in both the observation group and the control group were higher than those before treatment,and the observation group was lower than the control group,and the difference was statistically significant(P<0.05). The no-reflow phenomenon in the observation group was lower than that in the control group,the complete fall rate of ST segment2 h after PCI was higher than that in the control group,and the cTFC in the observation group after PCI was lower than that in the control group,with statistical significance(P<0.05). 30 d and 60 d after treatment,the levels of left ventricular end-diastolic diameter(LVEDD)in the observation group and the control group were lower than those before treatment,and the observation group was lower than the control group,and the levels of left ventricular ejection fraction(LVEF)in the observation group and Compared with before treatment,the control group increased,and the observation group was higher than the control group,the difference was statistically significant(P<0.05). Conclusion Early intravenous thrombolysis of ticagrelor in the treatment of STEMI patients can effectively regulate blood coagulation function,improve clinical symptoms and improve cardiac function,and prevent the occurrence of adverse cardiovascular events,which is more effective than clopidogrel.