经皮冠脉介入术前应用替格瑞洛与氯吡格雷治疗急性ST段抬高型心肌梗死的效果比较

摘要
图/表
参考文献(15)
相关文章 (15)

全文: PDF (556 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的探讨经皮冠脉介入（PCI）术前应用替格瑞洛与氯吡格雷治疗急性ST 段抬高型心肌梗死（STEMI）的效果比较。方法选取2015年1月至2019年2月武汉科技大学附属孝感医院收治的接受PCI 治疗的112 例STEMI患者作为研究对象，按照随机数字表法分为替格瑞洛组与氯吡格雷组，每组各56 例。替格瑞洛组PCI 术前给予替格瑞洛片，氯吡格雷组PCI 术前给予硫酸氢氯吡格雷片。比较两组患者的PCI 指标、术后24 h 心肌酶学指标与N 末端B 型脑钠肽前体（NT-proBNP）水平的变化情况，随访6 个月统计两组患者不良心血管事件（不良心血管事件）的发生率。结果替格瑞洛组患者TIMI 血流分级优于氯吡格雷组，冠脉慢性血流发生率低于氯吡格雷组，差异有统计学意义（P＜0.05）；术后24 h 两组患者肌钙蛋白I、磷酸肌酸激酶同工酶、NT-proBNP 均低于治疗前，且替格瑞洛组肌钙蛋白I、磷酸肌酸激酶同工酶、NT-proBNP 均低于氯吡格雷组，差异均有统计学意义（P＜0.05）；随访6个月，替格瑞洛组不良心血管事件总发生率低于氯吡格雷组，差异有统计学意义（P＜0.05）。结论 PCI 术前应用替格瑞洛较应用氯吡格雷可更为良好地恢复患者冠脉血供，能够降低冠脉慢性血流发生率，减轻心肌损伤，具有降低预后不良心血管事件发生风险的明确功效。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章

关键词 ：急性心肌梗死, ST 段抬高, 替格瑞洛, 氯吡格雷, 经皮冠状动脉介入治疗

Abstract：Objective To compare the efficacy of ticagrelor and Clopidogrel in the treatment of acute ST-segment elevation myocardial infarction (STEMI) before percutaneous coronary intervention. Methods A total of 112 STEMI patients who received percutaneous coronary intervention (PCI) treatment in Xiaogan Hospital Affiliated to Wuhan University of Science and Technology from January 2015 to February 2019 were selected as research objects，and they were divided into Ticagrelor group and Clopidogrel group according to random number table method，with 56 cases in each group. Ticagrelor group was given Ticagrelor Tablets before PCI，and Clopidogrel group was given Clopidogrel Bisulfate Tablets before PCI. The changes of PCI indexes，myocardial enzymology indexes and N-terminal B-type brain natriuretic peptide precursor (NT-proBNP) level 24 h after operation were compared between the two groups. The incidence of adverse cardiovascular events in the two groups was calculated after 6 months follow-up. Results TIMI blood flow grading in Ticagrelor group was better than that in Clopidogrel group，the incidence of coronary chronic blood flow was lower than that in Clopidogrel group，and the differences were statistically significant (P＜0.05). Troponin I，phosphocatine kinase isoenzyme and NT-proBNP 24 h after surgery in the two groups were lower than those before treatment，and the troponin I，phosphocatine kinase isoenzyme and NT-proBNP in Ticagrelor group were lower than those in Clopidogrel group，the differences were statistically significant (P＜0.05). After 6 months of follow-up，the total incidence of adverse cardiovascular events in Ticagrelor group was lower than that in Clopidogrel group，and the difference was statistically significant (P＜0.05). Conclusion Compared with clopidogrel，the application of tigrelor before PCI can better restore coronary blood supply，reduce the incidence of chronic coronary blood flow，reduce myocardial injury，and have a clear effect of reducing the risk of adverse cardiovascular events.

Key words： Acute myocardial infarction ST-segment elevation Grillo Clopidogrel Percutaneous coronary intervention

收稿日期: 2021-03-17

作者简介: 李朋（1972-），男，硕士，副主任医师。

引用本文:

李朋；徐建辉；胡威. 经皮冠脉介入术前应用替格瑞洛与氯吡格雷治疗急性ST段抬高型心肌梗死的效果比较[J]. 中国当代医药, 2022, 29(1): 76-79.
LI Peng XU Jianhui HU Wei. Comparison of the efficacy of Ticagrelor and Clopidogrel in the treatment of acute ST-segment elevation myocardial infarction before percutaneous coronary intervention. 中国当代医药, 2022, 29(1): 76-79.

链接本文:

http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2022/V29/I1/76

[1]	刘洋，刘恒亮，陈奇，等.不同剂量替罗非班联合替格瑞洛对糖尿病STEMI 患者急诊PCI 的疗效观察[J].中国现代应用药学，2019，36（15）：1927-1931.
[2]	董艳丽，董淑娟.替格瑞洛片联合阿司匹林片用于经皮冠状动脉介入术的急性ST 段抬高型心肌梗死患者的临床研究[J].中国临床药理学杂志，2019，35（7）：614-616.
[3]	何文凯，崔永生，李明琰，等.替格瑞洛联合阿司匹林对不同性别急性心肌梗死PCI 手术患者近期疗效的影响[J].中国慢性病预防与控制，2018，26（12）：927-929.
[4]	肖童，刘媛，黄克钧，等.替格瑞洛序贯氯吡格雷在老年糖尿病合并急性冠脉综合征患者中的应用[J].临床心血管病杂志，2019，35（1）：19-23.
[5]	张健发，于雁飞，黄定，等.替格瑞洛联合替罗非班在ST段抬高型心肌梗死糖尿病患者急诊PCI 术中的应用和安全性[J].中国老年学杂志，2017，37（5）：1098-1101.
[6]	He MJ，Liu B，Sun DH，et al.One-quarter standard-dose ticagrelor better than standard-dose clopidogrel in Chinese patientswith stable coronary artery disease：a randomized，single-blind，crossover clinical study[J].Int J Cardiol，2016，7（215）：209-213.
[7]	中华医学会心血管病学分会.急性ST 段抬高型心肌梗死诊断和治疗指南[J].中华心血管病杂志，2015，43（5）：380-393.
[8]	中华医学会心血管病学分会介入心脏病学组，中国医师协会心血管内科医师分会血栓防治专业委员会，中华心血管病杂志编辑委员会.中国经皮冠状动脉介入治疗指南（2016）[J].中华心血管病杂志，2016，44（5）：382-400.
[9]	Mueller HS. Thrombolysis in myocardial infarction （TIMI）：update 1987[J].Klin Wochenschr，1988，66（Suppl 12）：93-101.
[10]	张明亮，沈玉华，张立敏，等.替格瑞洛对急性ST 段抬高型心肌梗死急诊经皮冠状动脉介入患者血小板聚集率及QT 离散度的影响[J].中国老年学杂志，2016，36（15）：3667-3669.
[11]	Meneveau N，Souteyrand G，Motreff P，et al. Optical coherence tomography to optimize results of percutaneous coronary intervention in patients with non-ST-elevation acute coronary syndrome： Results of the multicenter，randomized DOCTORS study （Does Optical Coherence Tomography Optimize Results of Stenting） [J].Circulation，2016，134（13）：906-917.
[12]	柳宁波，王冬梅，孙家安，等.替格瑞洛对急性ST 段抬高型心肌梗死再灌注后冠状动脉血流的影响[J].第三军医大学学报，2016，38（17）：1976-1981.
[13]	Park KH，Jeong MH，Ahn Y，et al.Comparison ofshort-term clinical outcomes between ticagrelor versusclopidogrel in patients with acute myocardial infarctionundergoing successful revascularization；from KoreaAcute Myocardial Infarction Registry-National Institute of Health[J].Int J Cardiol，2016，215：193-200.
[14]	Andreotti F，Rocca B，Husted S，et al.Antithrombotictherapy in the elderly：expert position paper of the European Society of Cardiology Working Group on Thrombosis[J].Eur Heart J，2015，36（46）：3238-3249.
[15]	冯六六，刘天华，史骏，等.替格瑞洛片联合阿司匹林片治疗老年急性ST 段抬高型心肌梗死的临床研究[J].中国临床药理学杂志，2018，34（13）：1494-1496，1507.