替格瑞洛联合阿司匹林对急性心肌梗死患者近远期预后的影响研究

Effects of ticagrelor combined with aspirin on short-term and long-term prognosis of patients with acute myocardial infarction

目的:研究替格瑞洛联合阿司匹林(Aspirin,APC)对急性心肌梗死(Acute myocardial infarction,AMI)患者近远期预后的影响。方法:选取2021年5月至2022年5月本院收治的88例急性心肌梗死经皮冠状动脉介入(Percutaneous coronary intervention,PCI)术后患者作为研究对象,随机分为APC组和联合组,各44例。APC组患者口服APC进行治疗,联合组患者在APC组基础上联合口服替格瑞洛进行治疗。在治疗6 m后,比较APC组和联合组患者的治疗效果、左心室舒张末期内径(Left ventricular end diastolic diameter,LVEDD)、左室短轴缩短率(Left ventricular fractional shortening,LVFS)值、左心室射血分数(Left ventricular ejection fraction,LVEF)和不良反应发生率,随访1 y后观察主要不良心血管事件(Major adverse cardiovascular events,MACE)发生率。结果:联合组患者治疗有效率高于APC组(P<0.05)。治疗6 m后,APC组和联合组患者LVEDD水平降低,且联合组明显低于APC组(P<0.05);APC组和联合组患者LVFS、LVEF水平明显升高,且联合组明显高于APC组(P<0.05)。两组患者心律失常、消化道出血、牙龈出血不良反应发生率无明显差异(P>0.05)。随访1 y后,两组MACE发生率无明显差异(P>0.05)。结论:替格瑞洛联合APC治疗AMI能够提高治疗有效率,提高患者的心功能,促进患者预后。

Objective:To study the effects of ticagrelor combined with aspirin(APC)on short-term and long-term prognosis of patients with acute myocardial infarction(AMI).Methods:A total of 88 patients with AMI undergoing percutaneous coronary intervention(PCI)in the hospital were enrolled as the research objects between May 2021 and May 2022,and they were randomly divided into APC group(oral APC)and combination group(oral ticagrelor combined with AP),44 cases in each group.After 6 months of treatment,curative effect,left ventricular end diastolic diameter(LVEDD),left ventricular fractional shortening(LVFS),left ventricular ejection fraction(LVEF)and incidence of adverse reactions were compared between the two groups.After 1 year of follow-up,incidence of major adverse cardiovascular events(MACE)was observed.Results:The response rate of treatment in combination group was higher than that in APC group(P<0.05).After 6 months of treatment,LVEDD was decreased,which was significantly lower in combination group than APC group(P<0.05),while LVFS and LVEF are significantly increased,which were significantly higher in combination group than APC group(P<0.05).There was no significant difference in the incidence of adverse reactions(arrhythmia,gastrointestinal bleeding,gingival bleeding)between the two groups(P>0.05).After 1 year of follow-up,there was no significant difference in the incidence of MACE between the two groups(P>0.05).Conclusion:Ticagrelor combined with APC can increase response rate of treatment,improve cardiac function and promote prognosis of patients with AMI.