贵州医科大学学报

2016, v.41;No.188(05) 584-586+593

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STEMI患者行PCI术前给予替格瑞洛的疗效
Efficacy Observation of Ticagrelor Treatment Prior to STEMI Patients Treated with PCI Surgery

滕光磊;李伟;吴立荣;
TENG Guanglei;LI Wei;WU Lirong;Teaching Division of Internal Medicine,Guizhou Medical University;Department of Cardiovascular Medicine,Affiliated Hospital of Guizhou Medical University;

摘要(Abstract):

目的:观察行急诊经皮冠状动脉介入(PCI)术前给予替格瑞洛对急性ST段抬高型心肌梗死(STEMI)患者心肌组织灌注及疗效的影响。方法:90例成功行急诊PCI治疗的STEMI患者,随机均分为观察组和对照组;行PCI术前,观察组给予负荷剂量的替格瑞洛(180 mg),对照组给予负荷剂量的氯吡格雷(600 mg);术后即刻采用心肌梗死溶栓治疗(TIMI)血流分级和术后2 h ST段回落程度(STR)评估患者术后心肌组织灌注水平,比较患者PCI术后1周和1月时的左室射血分数(LVEF)、左室舒张末径(LVEDD)、心源性死亡、再次发生心肌梗塞及再次血运重建心脏主要不良事件的发生率。结果:与术前比较,2组患者术后TIMI血流0~2级患者比例降低(P<0.05),观察组降低更明显(P<0.05);观察组术后2 h STR良好的患者比例高于对照组(P<0.05);两组患者术后1月LVEF较术后1周明显升高,LVEDD明显降低(P<0.05),但同时点两组比较,差异无统计学意义(P>0.05);术后心源性死亡、再次发生心肌梗塞及再次血运重建发生率比较,差异无统计学意义(P>0.05)。结论:STEMI患者行PCI术前给予替格瑞洛的可改善患者术后心脏功能。
Objective: To observe the influence and efficacy of Ticagrelor treatment on the perfusion of myocardial tissue before emergent percutaneous coronary intervention( PCI) on patients with acute ST elevation myocardial infarction( STEMI). Methods: 90 patients with STEMI successfully performed emergent PCI were divided randomly into two groups,observation group and control group with equal number. Observation group was given 180 mg volume of Ticagrelor; control group was given600 mg volume of Clopidogrel. Immediate application of TIMI myocardial infarction reperfusion and 2 h postoperative ST-segment resolution( > 50%) were adopted to evaluate the perfusion level of myocardial tissue after PCI. Comparing LVEF,LVEDD,the incidence rates of cardiac function and MACE at 1week and 1 month after operation. Results: Comparing with before operation condition,proportion of both groups patients with TIMI flow grades of 0 to 2 has reduced( P < 0. 05),observation group has reduced significantly( P < 0. 05); proportion of 2 h postoperative ST-segment patients was higher than that of control group( P < 0. 05). LVEF of both groups has improved significantly 1 week after operation,LVEDD has reduced significantly( P < 0. 05); meanwhile,the difference of same time points comparison of both groups showed no statistical significance( P > 0. 05). The incidence rates of cardiac function and major adverse cardiovascular events( MACE) comparison showed no statistical difference( P > 0. 05). Conclusion: The STEMI patients given Ticagrelor before PCI were proved to improve postoperative cardio function.

关键词(KeyWords): 替格瑞洛;氯吡格雷;心肌梗塞,ST段抬高型;血管成形术,经腔,经皮冠状动脉
ticagrelor;clopidogrel;myocardial infarction,ST elevation;angioplasty,transluminal,percutaneous coronary

Abstract:

Keywords:

基金项目(Foundation): 贵州医科大学附院博士基金[gY Fybj(2016)01]

作者(Author): 滕光磊;李伟;吴立荣;
TENG Guanglei;LI Wei;WU Lirong;Teaching Division of Internal Medicine,Guizhou Medical University;Department of Cardiovascular Medicine,Affiliated Hospital of Guizhou Medical University;

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DOI: 10.19367/j.cnki.1000-2707.2016.05.023

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