西洛他唑抗血小板治疗在急性心肌梗死支架植入术后患者中的应用效果

Application effect of cilostazol antiplatelet therapy in patients with acute myocardial infarction after stent implantation

目的探讨西洛他唑抗血小板治疗在急性心肌梗死(AMI)支架植入术后患者中的应用效果。方法选取2020年7月至2022年7月收治的108例AMI患者作为研究对象,按照入院先后顺序将其分为对照组(54例)和研究组(54例)。对照组应用阿司匹林+氯吡格雷治疗,研究组在对照组基础上加用西洛他唑治疗。比较两组的治疗效果。结果治疗后,研究组的血小板聚集率(PAR)、P-选择素水平低于对照组,差异具有统计学意义(P<0.05);治疗后,两组的血小板平均体积(MPV)比较,差异无统计学意义(P>0.05)。治疗后,研究组的基质金属蛋白酶-9(MMP-9)、基质金属蛋白酶抑制剂-1(TIMP-1)、肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白T(cTnT)、miR-133a水平低于对照组,miR-335水平高于对照组,差异具有统计学意义(P<0.05)。研究组的心血管不良事件总发生率显著低于对照组,差异具有统计学意义(P<0.05)。结论西洛他唑抗血小板治疗用于AMI支架植入术后患者能抑制血小板活化和聚集,调节血清学指标水平,且心血管不良事件发生率低,具有较高的应用价值。

Objective To explore the application effect of cilostazol antiplatelet therapy in patients with acute myocardial infarction(AMI)after stent implantation.Methods A total of 108 patients with AMI admitted from July 2020 to July 2022 were selected as the research objects,and the patients were divided into control group(54 cases)and study group(54 cases)according to the order of admission.The control group was treated with aspirin+clopidogrel,and the study group was treated with cilostazol on the basis of the control group.The therapeutic effects of the two groups were compared.Results After treatment,the platelet aggregation rate(PAR)and P-selectin level in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05);after treatment,there was no significant difference in mean platelet volume(MPV)between the two groups(P>0.05).After treatment,the levels of matrix metalloproteinase-9(MMP-9),tissue inhibitor of metalloproteinases-1(TIMP-1),creatine kinase-MB(CK-MB),cardiac troponin T(cTnT)and miR-133a in the study group were lower than those in the control group,and level of the miR-335 was higher than that in the control group,and the differences were statistically significant(P<0.05).The total incidence of cardiovascular adverse events in the study group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Cilostazol antiplatelet therapy for patients after AMI stent implantation can inhibit platelet activation and aggregation,regulate the levels of serological indicators,and has a low incidence of cardiovascular adverse events,which has high application value.