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

发布时间：2018-05-30 14:25

  本文选题：急性心肌梗死 + 替格瑞洛　； 参考：《第三军医大学学报》2016年17期

【摘要】：目的探讨急性ST段抬高型心肌梗死(acute ST-segment elevation myocardial infarction,ASTEMI)患者术前服用负荷量替格瑞洛对急诊经皮冠状动脉介入(percutaneous coronary interventions,PCI)术中冠状动脉血流及预后的影响。方法将127例ASTEMI并行急诊PCI患者分为替格瑞洛组(n=62)及氯吡格雷组(n=65),术前分别给予替格瑞洛180 mg、氯吡格雷600 mg,比较两组基本情况、术后冠脉血流及术后6个月主要心血管不良事件,包括急性及亚急性支架内血栓、再发心绞痛及心肌梗死、"罪犯"血管再次血运重建、再次住院和死亡等。结果氯吡格雷组与替格瑞洛组基本临床资料、冠脉造影情况、术后心肌酶峰值及左室射血分数差异均无统计学意义(P0.05);氯吡格雷组与替格瑞洛组术后梗死相关血管无复流发生率(分别为15.2%、3.2%)、校正TIMI血流帧数计数[分别为(28.4±13.6)、(23.2±7.4)帧]、术后心肌酶达峰时间[分别为(19.0±8.3)、(16.0±5.9)h]、2 h心电图ST段回落指数≥50%比例(分别为76.9%、91.9%)差异有统计学意义(P0.05);替格瑞洛组6个月随访复合终点事件发生率较氯吡格雷组明显降低(P0.05)。结论急诊PCI前负荷量替格瑞洛可明显改善梗死相关血管冠脉血流、心肌灌注及临床预后。
[Abstract]:Objective to investigate the effect of tigrilol on coronary blood flow and prognosis in patients with acute St segment elevation myocardial infarction (St segment elevation myocardial infarction) during percutaneous coronary intervention. Methods 127 patients with ASTEMI and emergency PCI were divided into two groups: tigrilol group (n = 62) and clopidogrel group (n = 65). Before operation, they were given tigrilol 180 mg and clopidogrel 600 mg, respectively. The coronary blood flow after operation and the main adverse cardiovascular events at 6 months after operation were compared between the two groups. These include acute and subacute stent thrombosis, recurrent angina pectoris and myocardial infarction, re-revascularization, re-hospitalization and death. Results the basic clinical data of clopidogrel group and tigrilol group, coronary angiography, There was no significant difference in myocardial enzyme peak and left ventricular ejection fraction (P 0.05), no reflow rate of infarct-related vessels in clopidogrel group and tigrilol group (15.2g / 3.2g / g, corrected TIMI flow frame count = 28.4 卤13.6 / 23.2 卤7.4), respectively. There was significant difference in the peak time of myocardial enzyme [19.0 卤8.3 卤16.0 卤5.9 hours] 2 h ECG St segment receding index 鈮，

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