氯吡格雷联合溶栓治疗STEMI患者效果及对心肌损伤标志物的影响

Effect of Clopidogrel combined with thrombolysis in patients with STEMI and its effect on myocardial injury markers

目的探析对ST段抬高型心肌梗死(STEMI)患者应用氯吡格雷联合溶栓治疗的临床疗效及对心肌损伤标志物的影响。方法抽选2018年8月-2021年8月期间南城县人民医院收治的STEMI患者60例,随机分为对照组、研究组各30例,对照组接受溶栓治疗,研究组接受氯吡格雷+溶栓治疗。对比2组的疗效、心肌损伤标志物、炎性因子、心功能、预后。结果研究组的总有效率高于对照组(P<0.05);研究组的肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白T(cTnT)水平均低于对照组(P<0.05);研究组的白介素-6(IL-6)、肿瘤坏死因子α(TNF-α)水平均低于对照组(P<0.05);研究组的左室射血分数(LVEF)高于对照组,左室舒张末期内径(LVEDd)低于对照组(P<0.05);研究组的再梗死率、再心绞痛率、心力衰竭率均低于对照组(P<0.05)。结论对STEMI患者应用氯吡格雷联合溶栓治疗,可提高疗效,降低心肌损伤程度,减轻炎症,且预后良好,值得临床借鉴。

Objective To explore the clinical eficacy of clopidogrel combined with thrombolysis in patients with ST segment elevation myocardial infarction(STEMI)and its effect on myocardial injury markers.MethodsA total of 60 patients with STEMI treated in our hospital from August 2018 to August 2021 were selected and divided into groups according to random sampling method,namely control group and study group,with 30 cases in each group.The control group received thrombolytic therapy,and the study group received clopidogrel+thrombolytic therapy.The curative effect,myocardial injury markers,inflammatory factors,cardiac function and prognosis of the two groups were evaluated and compared.ResultsThe total effective rate of the study group was higher than that of the control group(P<0.05);The levels of creatine kinase isoenzyme(CK-MB)and cardiac troponin(cTnT)in the study group were lower than those in the control group(P<0.05);Interleukin-6(IL-6)and tumor necrosis factor in the study groupα(TNF-α)The rates of reinfarction,angina pectoris and heart failure in the study group were lower than those in the control group(P<0.05);The left ventricular ejection fraction(LVEF)in the study group was higher than that in the control group,and the left ventricular end diastolic diameter(LVEDd)was lower than that in the control group(P<0.05).ConclusionClopidogrel combined with thrombolysis in patients with STEMI can expand the curative effect,reduce the degree of myocardial injury,reduce inflammation,and have a good prognosis.It is an effective and feasible treatment option,which is worthy of extensive clinical reference.