替格瑞洛联合阿司匹林对急性心肌梗死PCI患者术后血小板参数及心电图的影响

摘要

Objective To investigate the effect of ticagrelor combined with aspirin on platelet parameters and electrocardiogram in patients with acute myocardial infarction after PCI. Methods Seventyeight patients with acute myocardial infarction who underwent PCI in our hospital between January 2013 and April 2015 were randomized into study group and control group,39 cases in each group. The control group received routine symptomatic treatment,while the study group was treated with ticagrelor combined with aspirin. The changes of platelet parameters[platelet count (PLT),mean platelet volume(MPV),plateletcrit(PCT)], cardiac function indexes[left ventricular ejection fraction (LVEF),left ventricular end diastolic diameter(LVEDd)]and electrocardiogram[body surface electrocardiogram QT dispersion(QTd)]in the two groups before and after treatment were observed. Results After treatment,PLT in the two groups were significantly lower than those before treatment,while MPV,LVEF and LVEDd were significantly higher. QTd was significantly shortened; After treatment,PLT in the study group was significantly lower than that ion control group,while MPV,LVEF,LVEDd,QTd was significantly shorter (P < 0. 05). Conclusion Ticagrelor combined with aspirin can effectively inhibit the activity of platelet,improve myocardial function and shorten QTd in patients with acute myocardial infarction after PCI.%目的 探讨替格瑞洛联合阿司匹林对急性心肌梗死PCI患者术后血小板参数及心电图的影响.方法 随机数字表法将2013年1月至2015年4月我院收治的78例急性心肌梗死PCI患者分为研究组和对照组各39例,对照组常规对症治疗,研究专组另实施替格瑞洛联合阿司匹林治疗,观察两组治疗前后血小板参数[血小板计数(PLT)、平均血小板体积(MPV)、血小板压积(PCT)]、心功能指标[左心室射血分数(LVEF)、左心室舒张末期内径(LVEDd)]及心电图[体表心电图QT离散度(QTd)、ST段回落情况]变化.结果 与治疗前相较,两组治疗后PLT显著降低,MPV、LVEF、 LVEDd显著升高,QTd显著缩短; 治疗后与对照组相较,研究组PLT降低显著,MPV、LVEF、LVEDd升高显著,QTd缩短显著,研究组ST段回落良好率96. 87％明显高于对照组21. 86％ (P < 0. 05).结论 替格瑞洛联合阿司匹林有效抑制急性心肌梗死PCI患者术后血小板活性,从而提高患者心肌功能及有效缩短QTd,且ST段抬高回落良好.