阿司匹林联合小剂量替格瑞洛防治冠心病PCI术后血栓形成的效果及对心功能、凝血功能的影响

Effect of aspirin combined with low-dose ticagrelor on the prevention and treatment of thrombosis after PCI in patients with coronary heart disease and its influences on cardiac function and coagulation function

目的分析阿司匹林联合小剂量替格瑞洛防治冠心病经皮冠状动脉介入术(PCI)后血栓形成的效果及对心功能、凝血功能的影响。方法选取收治的112例行PCI术治疗的冠心病患者为研究对象,根据术后治疗方法不同将其分为氯吡格雷(LBGL)组(n=32)、替格瑞洛标准剂量(TGRL-S)组(n=40)和替格瑞洛低剂量(TGRL-L)组(n=40)。比较三组的治疗效果。结果术后6个月,TGRL-S组和TGRL-L组的微循环抵抗指数(MRI)、冠状动脉血流储备分数(CFR)、左心室射血分数(LVEF)均优于LBGL组(P<0.05)。术后6个月,TGRL-S组和TGRL-L组的血小板最大聚集率、纤维蛋白原(FIB)水平低于LBGL组(P<0.05)。术后1年,TGRL-S组和TGRL-L组的支架内管腔直径<30%的占比高于LBGL组(P<0.05);主要心血管不良事件(MACE)总发生率比较,TGRL-L组最低,其次TGRL-S组,LBGL组最高(P<0.05)。结论阿司匹林联合小剂量替格瑞洛用于冠心病PCI术后可明显改善心功能和凝血功能,MACE发生率更低,安全性高,值得推广。

Objective To analyze the effect of aspirin combined with low-dose ticagrelor on the prevention and treatment of thrombosis after percutaneous coronary intervention(PCI)in patients with coronary heart disease and its influences on cardiac function and coagulation function.Methods A total of 112 patients with coronary heart disease who underwent PCI were selected as the research objects.According to different postoperative treatment methods,the patients were divided into clopidogrel(LBGL)group(n=32),ticagrelor standard dose(TGRL-S)group(n=40)and ticagrelor low dose(TGRL-L)group(n=40).The therapeutic effects of the three groups were compared.Results At 6 months after operation,the microcirculation resistance index(MRI),coronary flow reserve fraction(CFR)and left ventricular ejection fraction(LVEF)in the TGRL-S group and TGRL-L group were better than those in the LBGL group(P<0.05).At 6 months after operation,the maximum platelet aggregation rate and fibrinogen(FIB)level in the TGRL-S group and the TGRL-L group were lower than those in the LBGL group(P<0.05).At 1 year after operation,the proportion of stent lumen diameter<30%in the TGRL-S group and the TGRL-L group were higher than those in the LBGL group(P<0.05);the total incidence of major adverse cardiovascular events(MACE)was lowest in the TGRL-L group,followed by the TGRL-S group,and highest in the LBGL group(P<0.05).Conclusion Aspirin combined with low-dose ticagrelor can significantly improve cardiac function and coagulation function after PCI for coronary heart disease,with a lower incidence of MACE and high safety,which is worthy of promotion.