替格瑞洛联合曲美他嗪治疗冠心病的疗效及对血清hs-cTnT、D二聚体水平的影响

Efficacy of Ticagrelor Combined with Trimetazidine in the Treatment of Coronary Heart Disease and Its Effect on Serum hs-cTnT and D-dimer Levels

目的探讨替格瑞洛联合曲美他嗪治疗冠心病(CHD)的疗效及对血清高敏心肌肌钙蛋白T(hs-cTnT)、D二聚体(D-D)水平的影响。方法选择2022年8月至2024年2月成都市第三人民医院收治的CHD患者108例为研究对象,按照随机数字表法分为对照组(给予替格瑞洛治疗,n=54)和试验组(给予替格瑞洛联合曲美他嗪治疗,n=54)。对比两组治疗前(T_(0))、治疗4周后(T_(1))的心功能、心肌损伤标志物、氧化应激因子、炎性因子、血凝标志物、临床疗效及不良反应。结果与T_(0)时点比较,两组T_(1)时点左心室射血分数(LVEF)、谷胱甘肽过氧化物酶(GSH-Px)、超氧化物歧化酶(SOD)水平均升高,且试验组明显高于对照组(P<0.05)。与T_(0)时点比较,两组T_(1)时点左室舒张末径(LVEDD)、左室收缩末径(LVESD)、血清心肌肌钙蛋白Ⅰ(cTnⅠ)、N末端B型利钠肽原(NT-proBNP)、hs-cTnT、血清肌酸激酶同工酶(CK-MB)、丙二醛(MDA)、超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子α(TNF-α)、血清纤维蛋白原(FIB)、D-D水平均降低,且试验组明显低于对照组(P<0.05)。试验组总有效率高于对照组(P<0.05),两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论CHD患者应用替格瑞洛联合曲美他嗪治疗,可调节血清hs-cTnT及D-D水平,抑制炎性因子产生,调控氧化应激反应,减轻心肌损伤程度,改善心功能,增加冠脉血流,进一步提高临床治疗效果。

Objective To explore the efficacy of ticagrelor combined with trimetazidine in the treatment of coronary heart disease(CHD)and its effect on serum levels of high-sensitivity cardiac troponin T(hs-cTnT)and D-dimer(D-D).Methods A total of 108 CHD patients admitted to the Third People's Hospital of Chengdu from August 2022 to February 2024 were selected as the study objects.They were divided into a control group(treated with ticagrelor,n=54)and an experimental group(treated with ticagrelor combined with trimetazidine,n=54)according to the random number table method.The cardiac function,myocardial injury markers,oxidative stress factors,inflammatory factors and coagulation markers before treatment(T_(0))and after 4 weeks of treatment(T_(1)),clinical efficacy and adverse reactions were compared.Results At T_(1),the left ventricular ejection fraction(LVEF),and levels of glutathione peroxidase(GSH-Px)and superoxide dismutase(SOD)in both groups were higher than those at T_(0),and the above indicators in the experimental group were higher than those in the control group(P<0.05).Compared to those at T_(0),the left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD),and serum levels of cardiac troponin I(cTnI),N-terminal B-type pronnatriuretic peptide(NT proBNP),hs-cTnT,creatine kinase isoenzyme(CK-MB),malondialdehyde(MDA),hypersensitive C-reactive protein(hs-CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),fibrinogen(FIB),and D-D were significantly reduced at T_(1),and the above indicators in the experimental group were lower than those in the control group(P<0.05).The total effective rate in the experimental group was higher than that in the control group(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Ticagrelor combined with trimetazidine can regulate serum hs-cTnT and D-D levels,inhibit inflammatory factors,regulate oxidative stress response,reduce myocardial injury,improve cardiac function,increase coronary blood flow,and further enhance clinical efficacy in the treatment of CHD patients.