负荷量替格瑞洛在急性心肌梗死急诊经冠状动脉介入术的有效性和安全性研究

Efficacy and safety of loading dose of ticagrelor in emergency PCI for acute myocardial infarction

目的探讨负荷量替格瑞洛在急性心肌梗死(AMI)急诊经皮冠状动脉介入治疗(PCI)中应用的有效性和安全性。方法将该院2018年1月‐6月收治的80例行急诊PCI治疗的AMI患者随机分为观察组和对照组各40例。对照组急诊PCI术前即刻嚼服阿司匹林+氯吡格雷。观察组急诊PCI术前即刻嚼服阿司匹林+替格瑞洛。术后对照组给予氯吡格雷,观察组给予替格瑞洛。比较两组的血小板聚集率、心肌灌注水平、左室EF值、心血管不良事件(MACE)等。结果观察组心肌灌注分组级(TMPG)3级的例数多于对照组,ST段完全回落率高于对照组,比较差异有统计学意义(P <0.05)。观察组术后2 h、24 h的血小板聚集率低于对照组,比较差异有统计学意义(P <0.05)。观察组术后1周的左室射血分数(LVEF)高于对照组。观察组随访期间的MACE、不良反应少于对照组,差异有统计学意义(P <0.05)。结论负荷量替格瑞洛能够抑制血小板聚集,改善心肌灌注,减少MACE的发生。

【Objective】To investigate the efficacy and safety of loading ticagrelor in emergency percutaneous coronary intervention(PCI)for acute myocardial infarction(AMI).【Methods】Eighty patients with AMI who received PCI from January to June 2018 were randomly divided into the observation group and the control group,40 cases in each group.The control group chewed aspirin and clopidogrel 30 minutes before the operation.The observation group chewed aspirin and ticagrelor 30 minutes before the operation.After the operation,the control group was given clopidogrel,and the observation group was treated with ticagrelor.The platelet aggregation rate,myocardial perfusion level,left ventricular ejection fraction(LVEF),and major adverse cardiovascular events(MACE)were compared between the two groups.【Results】The platelet aggregation rate of the observation group was lower than that of the control group at 2 hour and 24 hour after operation,and the difference was statistically significant(P<0.05).The LVEF of the observation group was higher than that of the control group one week after operation,the number of TMPG grade 3 cases was more than that of the control group,and the complete ST segment regression rate was higher than that of the control group,and the difference was statistically significant(P<0.05).During the follow-up period,MACE and adverse reactions in the observation group were less than those in the control group,and the difference was statistically significant(P<0.05).【Conclusion】Ticagrelor can inhibit platelet aggregation,improve myocardial perfusion and reduce the incidence of MACE.