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

发布时间：2018-01-28 05:24

本文关键词： 急性心肌梗死替格瑞洛氯吡格雷 QT离散度血小板聚集率　出处：《中国老年学杂志》2016年15期 　论文类型：期刊论文

【摘要】：目的探讨行急诊经皮冠脉介入(PCI)术的急性ST段抬高性心肌梗死(STEMI)患者口服替格瑞洛对血小板聚集率及体表心电图QT离散度(QTd)的影响及临床意义。方法明确诊断为STEMI的患者68例随机分为替格瑞洛组与氯吡格雷组。观察两组在急诊PCI治疗前及治疗后血小板聚集率和QTd的变化。结果急诊PCI治疗前有22例出现室性心律失常,急诊PCI后,无室性心律失常出现,QTd在室性心律失常组较非室性心律失常组明显延长(P0.05);氯吡格雷组术后2、24 h血小板聚集率较术前均明显下降(P0.05);替格瑞洛组术后2、24 h血小板聚集率较术前均明显下降(P0.01);与氯吡格雷组比较,替格瑞洛组术后2、24 h血小板聚集率下降更明显(P0.05);氯吡格雷组QTd术后较术前明显降低(P0.05),替格瑞洛组QTd术后较术前明显降低(P0.01),与氯吡格雷组比较,替格瑞洛组下降更明显(P0.05);住院期间替格瑞洛组与氯吡格雷组出血事件发生率无明显差异(P0.05)。结论 STEMI患者行急诊PCI术前及术后应用替格瑞洛抗血小板治疗,可更快、更强地抑制血小板聚集,显著缩短QTd,减少恶性心律失常的发生率。
[Abstract]:Objective to investigate the effect of tigrilol on platelet aggregation rate and QT dispersion of surface electrocardiogram (ECG) in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing emergency percutaneous coronary intervention (PCI). Methods Sixty-eight patients with STEMI were randomly divided into two groups: tigril group and clopidogrel group. The platelet aggregation rate and QTd were observed before and after emergency PCI treatment. Results there were 22 cases of ventricular arrhythmia before emergency PCI treatment. After emergency PCI, no ventricular arrhythmia appeared QTD in the ventricular arrhythmia group than in the non-ventricular arrhythmia group significantly longer than the non-ventricular arrhythmia group. In clopidogrel group, the platelet aggregation rate at 24 h after operation was significantly lower than that before operation (P 0.05). The platelet aggregation rate at 24 h after operation in tigrilol group was significantly lower than that before operation (P 0.01). Compared with clopidogrel group, the platelet aggregation rate of tigrilol group decreased more significantly than that of clopidogrel group at 24 h after operation (P 0.05). Compared with clopidogrel group, clopidogrel group was significantly lower than that of preoperation in QTd group (P 0.05) and tigrilol group (P 0.01) after QTd operation, which was significantly lower than that in clopidogrel group. In tigrilol group, the decrease was more obvious than that in the control group (P 0.05). There was no significant difference in the incidence of bleeding events between the tigrilol group and clopidogrel group during hospitalization P0.05Conclusion the patients with STEMI were treated with tigrello antiplatelet therapy before and after emergency PCI. It can inhibit platelet aggregation more quickly, shorten QTD significantly, and reduce the incidence of malignant arrhythmia.
【作者单位】：佳木斯市中心医院心内科;深圳市第十人民医院心内科;佳木斯大学基础医学院;
【基金】：国家自然科学基金面上项目(No.81272854) 黑龙江省自然科学基金项目(No.D201129)
【分类号】：R542.22
【正文快照】： 血小板的激活、聚集、黏附是急性ST段抬高型心肌梗死(STEMI)发生的始动因素和发展的关键环节。急诊经皮冠状动脉介入(PCI)是治疗STEMI的最主要手段,急诊冠脉PCI可开通阻塞冠脉血管,及时恢复心肌血流灌注,是目前首选的再灌注治疗策略。我国最新版的《STEMI诊断和治疗指南》中指

【参考文献】