替格瑞洛联合急诊经皮冠状动脉介入治疗对ST段抬高型心肌梗死患者心肌损伤及血小板聚集程度的影响

摘要

目的 研究替格瑞洛联合急诊经皮冠状动脉介入(PCI)治疗对ST段抬高型心肌梗死(STEMI)患者心肌损伤、血小板聚集程度的影响.方法 选择接受PCI治疗的108例STEMI患者作为研究对象,采用随机数字表法分为替格瑞洛组和氯吡格雷组,分别接受PCI联合替格瑞洛治疗以及PCI联合氯吡格雷治疗.PCI术后评估心肌血流灌注情况,检测血清中心肌损伤指标以及血小板聚集指标.结果 PCI术后,替格瑞洛组患者的冠状动脉狭窄程度(TIMI)分级和心肌灌注(TMPG)分级均显著高于氯吡格雷组,校正TIMI帧计数(CTFC)以及无复流率均显著低于氯吡格雷组;PCI术后12h时,替格瑞洛组患者血清中肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、肌钙蛋白Ⅰ(cTnⅠ)、肌钙蛋白T(cTnT)、血小板活化因子(PAF)、血小板α颗粒膜蛋白-140(GMP-140)、血栓素B2(TXB2)的含量显著低于氯吡格雷组,6-酮-前列腺素F1α(6-keto-PGF1α)的含量显著高于氯吡格雷组.结论 急诊PCI围手术期应用替格瑞洛治疗STEMI能够更为有效的改善心肌血流灌注、减轻心肌细胞损伤、抑制血小板聚集.%Objective To study the effect of ticagrelor combined with emergency PCI therapy on myocardial damage and platelet aggregation degree in STEMI patients.Methods 108 cases of STEMI patients received PCI therapy were selected as the research object and randomly divided into ticagrelor group and clopidogrel group,separately received PCI combined withticagrelor therapy and clopidogrel combined withticagrelor therapy.Myocardial blood flow after PCI was evaluated,serum myocardial damage index and platelet aggregation index were determined.Results After PCI,TIMI grade and TMPG grade of ticagrelor group were significantly higher than those of clopidogrel group.CTFC and no flow rate were significantly lower than those ofclopidogrel group.12 h after PCI,serum CK,CK-MB,cTnⅠ,cTnT,PAF,GMP-140 and TXB2 contents of ticagrelor group were significantly lower than those of clopidogrel group.6-keto-PGFl-α content was significantly higher than that of clopidogrel group.Conclusions Perioperative PCI application of ticagrelor in STEMI can more effectivelly improve myocardial perfusion,reduce myocardial cell damage and inhibit platelet aggregation.