本文選題：急性心肌梗死 + 替格瑞洛��； 參考：《第三軍醫(yī)大學學報》2016年17期

【摘要】：目的探討急性ST段抬高型心肌梗死(acute ST-segment elevation myocardial infarction,ASTEMI)患者術前服用負荷量替格瑞洛對急診經皮冠狀動脈介入(percutaneous coronary interventions,PCI)術中冠狀動脈血流及預后的影響。方法將127例ASTEMI并行急診PCI患者分為替格瑞洛組(n=62)及氯吡格雷組(n=65),術前分別給予替格瑞洛180 mg、氯吡格雷600 mg,比較兩組基本情況、術后冠脈血流及術后6個月主要心血管不良事件,包括急性及亞急性支架內血栓、再發(fā)心絞痛及心肌梗死、"罪犯"血管再次血運重建、再次住院和死亡等。結果氯吡格雷組與替格瑞洛組基本臨床資料、冠脈造影情況、術后心肌酶峰值及左室射血分數差異均無統(tǒng)計學意義(P0.05);氯吡格雷組與替格瑞洛組術后梗死相關血管無復流發(fā)生率(分別為15.2%、3.2%)、校正TIMI血流幀數計數[分別為(28.4±13.6)、(23.2±7.4)幀]、術后心肌酶達峰時間[分別為(19.0±8.3)、(16.0±5.9)h]、2 h心電圖ST段回落指數≥50%比例(分別為76.9%、91.9%)差異有統(tǒng)計學意義(P0.05);替格瑞洛組6個月隨訪復合終點事件發(fā)生率較氯吡格雷組明顯降低(P0.05)。結論急診PCI前負荷量替格瑞洛可明顯改善梗死相關血管冠脈血流、心肌灌注及臨床預后。
[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 鹵13.6 / 23.2 鹵7.4), respectively. There was significant difference in the peak time of myocardial enzyme [19.0 鹵8.3 鹵16.0 鹵5.9 hours] 2 h ECG St segment receding index 鈮，

本文編號：1955622