替格瑞洛在STEMI患者介入术后中的应用及对血清NGAL、MMP-9水平的影响

Effect of ticagrelor on serum NGAL and MMP-9 levels in postoperative patients with STEMI

目的分析替格瑞洛在急性ST段抬高型心肌梗死(STEMI)患者介入术后的应用及对血清中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、基质金属蛋白酶-9(MMP-9)水平的影响。方法选定2020年1月至2022年1月住院的86例STEMI介入术患者,以随机法将其分为2组,每组43例。氯吡格雷组给予氯吡格雷治疗,替格瑞洛组给予替格瑞洛治疗,比较2组心肌损伤标志物、血清NGAL、MMP-9水平、TIMI血流分级、主要心血管不良事件(MACE)总发生率、不良反应总发生率。结果替格瑞洛组治疗后血清肌酸激酶同工酶(CK-MB)、肌钙蛋白I(cTnI)、NGAL、MMP-9水平均比氯吡格雷组低(P<0.05)。替格瑞洛组治疗后TIMI血流分级优于氯吡格雷组(P<0.05)。替格瑞洛组MACE总发生率(2.33%)低于氯吡格雷组(16.28%)(P<0.05)。替格瑞洛组MACE总发生率(4.65%)低于氯吡格雷组(9.30%),差异无统计学意义(P>0.05)。结论STEMI患者介入术后给予替格瑞洛,可有效减轻心肌细胞受损程度及冠脉硬化程度,改善血流分级,降低MACE发生率,且未见明显不良反应,具有一定的安全性。

Objective To analyze the effect of ticagrelor on serum neutrophil gelatinase-associated lipocalin(NGAL)and matrix metalloproteinase-9(MMP-9)levels in postoperative patients with acute ST-segment elevation myocardial infarction(STEMI).Methods A total of 86 postoperative patients with STEMI hospitalized in our hospital from January 2020 to January 2022 were enrolled and randomized 1∶1 to receive either clopidogrel(clopidogrel group,n=43)or ticagrelor(ticagrelor group,n=43).Myocardial injury markers,serum NGAL,MMP-9 levels,thrombolysis in myocardial infarction(TIMI)blood flow grade,total incidence of major adverse cardiovascular events(MACEs)and adverse drug reactions(ADRs)were compared between the two groups.Results After treatment,the levels of serum creatine kinase isoenzyme(CK-MB),troponin I(cTnI),NGAL and MMP-9 in ticagrelor group were significantly lower than those in clopidogrel group(P<0.05).The TIMI blood flow grade in ticagrelor group was significantly better than that in clopidogrel group(P<0.05).The total incidence of MACE in ticagrelor group was significantly lower than that in clopidogrel group(2.33%vs 16.28%,P<0.05).The total incidence of MACEs in ticagrelor group was comparable to clopidogrel group(4.65%vs 9.30%,P>0.05).Conclusion For postoperative patients with STEMI,ticagrelor can effectively reduce the degree of myocardial cell damage and artery stiffness,improve the blood flow grade,reduce the incidence of MACE,and it has a certain safety without obvious adverse reactions.