负荷剂量替格瑞洛对急性心肌梗死患者介入疗效后冠脉血流、左室重构及心肌酶谱的影响被引量：17

Effect of loading-dose ticagrelor on coronary blood flow,left ventricular remodeling and myocardial enzyme spectrum in patients with acute myocardial infarction after interventional therapy

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摘要目的:研究负荷剂量替格瑞洛对急性心肌梗死患者介入疗效后冠脉血流、左室重构及心肌酶谱的影响。方法:选择在我院接受急诊PCI治疗的86例急性心肌梗死患者并随机分为两组,替格瑞洛组在围手术期应用替格瑞洛治疗,氯吡格雷组在围手术期应用氯吡格雷治疗。PCI术后评估冠脉血流再灌注情况,测定血清心肌重构指标及心肌酶,行心脏彩超检查并测定心功能指标。结果:替格瑞洛组PCI术后的TIMI分级和TMPG分级均显著高于氯吡格雷组;替格瑞洛组术后24h时血清中基质金属蛋白酶9(MMP9)、B型利钠肽(BNP)、I型C端胶原前肽(CITP)、I型前胶原羧基端肽(PICP)、III型N端胶原前肽(PIIINP)以及肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、肌钙蛋白I(cTnI)、肌钙蛋白T(cTnT)的含量均显著低于氯吡格雷组;替格瑞洛组术后2周时的左室舒张末期内径(LVEDD)、左室收缩末期内径(LVSED)、左心室质量指数(LVMI)均显著低于氯吡格雷组,左心室射血分数(LVEF)显著高于对照组。结论:PCI围手术期负荷剂量替格瑞洛能够改善急性心肌梗死患者的冠脉血流灌注,减轻心室重构及心肌损伤。 Objective： To study the effect of loading-dose ticagrelor on coronary blood flow, left ventricular remodeling and myocardial enzyme spectrum in patients with acute myocardial infarction after interventional therapy. Methods： A total of 86 patients with acute myocardial infarction who received emergency PCI in our hospital were selected and randomly divided in- to two groups, ticagrelor group received perioperative ticagrelor therapy and clopidogrel group received perioperative clopi- dogrel therapy. After PCI, coronary blood flow reperfusion was evaluated, serum myocardial remodeling indexes and myocardi- al enzymes were determined, and cardiac color Doppler ultrasonography was conducted to determine the cardiac function inde- xes. Results： TIMI grading and TMPG grading of ticagrelor group after PCI were significantly higher than those of clopidogrel group ; serum MMP9, BNP, CITP, PICP, PIIINP, CK, CK-MB, cTnI and cTnT content of ticagrelor group 24h after opera-tion were significantly lower than those of clopidogrel group; LVEDD, LVSED and LVMI of ticagrelor group 2 weeks after op- eration were significantly lower than those of elopidogrel group while LVEF was significantly higher than that of elopidogrel group. Conclusion： Peri-PCI loading-dose ticagrelor can improve coronary blood perfusion and reduce ventrieular remodeling and myocardial injury in patients with acute myocardial infarction.

作者解晓蕊杨朴

机构地区西安医学院附属宝鸡医院心血管内科陕西省宝鸡市中心医院心血管内科

出处《海南医学院学报》 CAS 2016年第24期2951-2954,共4页 Journal of Hainan Medical University

基金陕西省自然科学基金(SX461322-51C)~~

关键词急性心肌梗死替格瑞洛心室重构心肌酶谱 Acute myocardial infarction Ticagrelor Ventricular remodeling Myocardial enzyme spectrum

分类号 R542.22 [医药卫生—心血管疾病]

作者简介解晓蕊（1971-），女，陕西周至人，学士，副主任医师，电话：0917-3619511、13571702892，E-mail：xr3xuelh829@yeah．net。

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1刘宇,丁志坚,曹海涛,陈增光,周长乐.替格瑞洛对急性ST段抬高性心肌梗死行直接PCI手术患者疗效观察[J].实用临床医药杂志,2014,18(24):106-107. 被引量：7
2柳宁波,王冬梅,孙家安,汝磊生,彭育红,赵玉英,张莉,王刚,李志文.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[J].第三军医大学学报,2016,38(17):1976-1981. 被引量：39

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