西洛他唑联合替格瑞洛对急性心肌梗死PCI后患者血小板功能及心功能的影响

Effect of cilostazol combined with ticagrelor on platelet function and cardiac function in patients with acute myocardial infarction after PCI

目的探讨西洛他唑联合替格瑞洛对急性心肌梗死经皮冠状动脉介入(PCI)后患者血小板功能及心功能的影响。方法随机对照研究。抽取2021年1月至2023年1月于驻马店市第一人民医院行PCI治疗的急性心肌梗死患者90例,依据随机数字表法分为对照组与观察组,每组45例。所有患者均行PCI治疗,PCI后,对照组给予替格瑞洛治疗,观察组给予西洛他唑联合替格瑞洛治疗,两组均持续治疗6个月。比较两组血小板功能、心功能、心肌酶指标,并统计两组治疗期间不良反应发生情况。结果治疗后,两组血小板反应指数、血小板最大聚集率、乳酸脱氢酶、肌激酶同工酶、肌酸激酶均较同组治疗前降低,且观察组低于对照组(P<0.05);治疗6个月后,两组左心室射血分数、左心室舒张末期内径、左心室收缩末期内径较同组治疗前升高,且观察组高于对照组(P<0.05)。观察组治疗期间不良反应发生率(6.67%,3/45)与对照组(13.33%,6/45)比较差异未见统计学意义(P>0.05)。结论西洛他唑联合替格瑞洛可改善急性心肌梗死PCI后患者血小板功能及心功能,还可改善心肌酶指标,且不会增加不良反应,安全性良好。

Objective To investigate the effects of cilostazol combined with ticagrelor on platelet function and cardiac function in patients with acute myocardial infarction after percutaneous coronary intervention(PCI).Methods A total of 90 patients with acute myocardial infarction who underwent PCI in the First People’s Hospital of Zhumadian from January 2021 to January 2023 were selected for the randomized controlled study.And they were divided into the control group and the observation group according to the random number table method,with 45 cases in each group.All patients underwent PCI treatment.After PCI,the control group was treated with ticagrelor,while the observation group was treated with cilostazol combined with ticagrelor;both groups were treated continuously for 6 months.The platelet function,cardiac function,and myocardial enzyme indicators were compared between the two groups.The incidence of adverse reactions during the treatment of the two groups were recorded.Results After treatment,the platelet reaction index,maximum platelet aggregation rate,lactate dehydrogenase,muscle kinase isoenzyme,and creatine kinase in both groups decreased compared with the same group before treatment,and the above indicators in the observation group were lower than those in the control group(P<0.05).After 6 months of treatment,the left ventricular ejection fraction,left ventricular end diastolic diameter,and left ventricular end systolic diameter in both groups increased compared with the same group before treatment,and the above indicators in the observation group were higher than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions during treatment between the observation group(6.67%,3/45)and the control group(13.33%,6/45),P>0.05.Conclusions The combination of cilostazol and ticagrelor can improve platelet function and cardiac function in patients with acute myocardial infarction after PCI.It can also improve myocardial enzyme indicators without increasing adverse reactions,which has good safety.