| 叶 莎,郑敏英,张倩榕,金爱萍,王春亚.替格瑞洛联合比伐芦定用于STEMI患者急诊行PCI术的疗效分析[J].,2019,19(4):680-683 |
| 替格瑞洛联合比伐芦定用于STEMI患者急诊行PCI术的疗效分析 |
| Analysis of the Efficacy of Ticagrelor Combined with Bivalirudin in the Treatment of STEMI Patients Undergoing PCI |
| 投稿时间：2018-05-28 修订日期：2018-06-23 |
| DOI：10.13241/j.cnki.pmb.2019.04.017 |
| 中文关键词: 替格瑞洛 比伐芦定 STEMI PCI 无复流 |
| 英文关键词: Ticagrelor Bivalirudin STEMI PCI No-reflow |
| 基金项目:陕西省重点研发计划项目(2017SF-238) |
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| 中文摘要: |
| 摘要 目的：分析替格瑞洛联合比伐芦定用于急性ST段抬高型心肌梗死(STEMI)患者急诊行经皮冠状动脉介入手术(PCI)的疗效。方法：回顾性分析2016年10月-2017年10月我院收治的71例行急诊PCI的STEMI患者，根据药物使用方案的不同分为研究组(n=35)和对照组(n=36)，两组术前均给予患者阿司匹林300 mg和替格瑞洛180 mg进行治疗，对照组术中采用肝素，研究组术中采用比伐卢定，对比两组患者的无复流发生率、内皮素(ET)、超氧化物歧化酶(SOD)、细胞间黏附分子-1(ICAM-1)、C反应蛋白(CRP)水平、心脏功能和主要不良心脏事件发生率。结果：研究组PCI术后的无复流发生率[8.6%(3/35)]显著低于对照组[27.8%(10/36)](P＜0.05)，术后左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、血清ICAM-1、CRP、ET水平均明显低于术前，且均显著低于对照组(P＜0.05)，术后左心室射血分数(LVEF)、血清SOD水平高于术前，且显著高于对照组(P＜0.05)。研究组术后3个月的主要不良心脏事件发生率[11.4%(4/34)]低于对照组[27.8%(10/36)](P＜0.05)。结论：在STEMI患者急诊行PCI术中，采用替格瑞洛联合比伐芦定进行治疗可有效降低患者的无复流发生率，减轻血管壁的炎性反应，改善心脏功能，且患者的主要不良心脏事件发生率较低。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the efficacy of ticagrelor and bivalirudin in the emergency percutaneous coronary intervention (PCI) in patients with acute st-segment elevation myocardial infarction (STEMI). Methods: A retrospective analysis was conducted on the STEMI patients of 71 emergency PCI patients admitted to our hospital from October 2016 to October 2017. According to the different drug use regimens, they were divided into the research group(n=35) and the control group(n=36). Two groups of patients were treated with aspirin 300mg and ticagrelor 180mg before surgery, and heparin was used in the control group, and the research group was used for the treatment of the bivalirudin. Compared to two groups of patients the incidence of no reflow, endothelin (ET), superoxide dismutase (SOD) and intercellular adhesion molecule 1 (ICAM - 1), c-reactive protein (CRP) level and heart function and the incidence of major ad- verse cardiac events. Results: The incidence of uncomplicated flow after PCI in the research group was 8.6% (3/35), which was lower than 27.8% (10/36) in the control group (P<0.05). Left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), serum ICAM-1, CRP, and ET levels were significantly lower than those before surgery, and were significantly lower than those of the control group (P<0.05). The postoperative left ventricular ejection fraction (LVEF) and serum SOD levels were higher than those before surgery and significantly higher than those of the control group (P<0.05). The incidence rate of major adverse cardiac events in the research group was 11.4% (4/34), which was lower than 27.8% (10/36) in the control group(P<0.05). Conclusion: Ticagrelor com- bined with bivalirudin can effectively reduce the incidence of no reflow and reduce the inflammatory reaction of blood vessel walls, im- prove heart function and the incidence of major adverse cardiac events of STEMI patients undergoing PCI. |
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