Objective To compare the impact on TIMI blood flow grade and cardiac function of acute ST-segment elevation myocardial infarction patients treated by PCI between clopidogrel and ticagrelor.Methods A total of 168 patients with acute ST-segment elevation myocardial infarction were selected in Taihe Hospital of Shiyan from May 2013 to December 2015,all of them received thrombolytic therapy and delayed PCI,and they were divided into clopidogrel group and ticagrelor group according to the random number table,each of 84 cases.Patients of clopidogrel group received clopidogrel before and after PCI,while patients of ticagrelor group received ticagrelor before and after PCI;both groups continuously treated for 12 months.TIMI blood flow grade before and after treatment,and index of cardiac function (including LVEF and LVEDD) after treatment were compared between the two groups,incidence of adverse during the treatment was observed,so was incidence of MACCE and cardiovascular death during the 6-month follow-up.Results No statistically significant differences of TIMI blood flow grade was found between the two groups before treatment (P ＞ 0.05),while TIMI blood flow grade of ticagrelor group was statistically significantly better than that of clopidogrel group (P ＜ 0.05).After treatment,LVEF of ticagrelor group was statistically significantly higher than that of clopidogrel group,while LVEDD of ticagrelor group was statistically significantly shorter than that of clopidogrel group (P ＜0.05).No statistically significant differences of incidence of adverse reactions was found during the treatment (P ＞ 0.05).During the 6-month follow-up,risk of MACCE and cardiovascular death of ticagrelor group was statistically significantly lower than that of clopidogrel group,respectively (P ＜ 0.05).Conclusion Compared with clopidogrel,ticagrelor can more effectively improve the TIMI blood flow grade and cardiac function of acute ST-segment elevation myocardial infarction patients treated by PCI,reduce the risk of MACCE and cardiovascular death,and is more safe.%目的 比较氯吡格雷和替格瑞洛对急性ST段抬高型心肌梗死患者经皮冠状动脉介入术(PCI)后TIMI分级及心功能的影响.方法 选取2013年5月-2015年12月于十堰市太和医院溶栓治疗后行择期PCI的急性ST段抬高型心肌梗死患者168例,根据随机数字表法分为氯吡格雷组与替格瑞洛组,每组84例.氯吡格雷组患者于PCI前后予以氯吡格雷治疗,替格瑞洛组患者于PCI前后予以替格瑞洛治疗;两组患者均连续治疗12个月.比较两组患者治疗前后TIMI分级,治疗后心功能指标[左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)],并观察两组患者治疗期间不良反应发生情况和随访6个月两组患者主要不良心脑血管事件(MACCE)、心血管相关死亡发生情况.结果 治疗前两组患者TIMI分级比较,差异无统计学意义(P＞0.05);治疗后替格瑞洛组患者TIMI分级优于氯吡格雷组(P＜0.05).治疗后替格瑞洛组患者LVEF高于氯吡格雷组,LVEDD小于氯吡格雷组(D＜0.05).两组患者治疗期间不良反应发生率比较,差异无统计学意义(P＞0.05).随访6个月替格瑞洛组患者MACCE发生风险及心血管相关死亡风险低于氯吡格雷组(P＜0.05).结论 与氯吡格雷相比,替格瑞洛可更有效地改善急性ST段抬高型心肌梗死患者PCI后TIMI分级、心功能,降低患者MACCE发生风险及心血管相关死亡风险,且安全性较高.
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