| 毛艳阳,王军强,王晨霞,等.替格瑞洛联合溶栓治疗ST段抬高型心肌梗死疗效及对患者心肌损伤标志物与炎性因子水平的影响[J].安徽医药,2016,20(3):551-554. |
| 替格瑞洛联合溶栓治疗ST段抬高型心肌梗死疗效及对患者心肌损伤标志物与炎性因子水平的影响 |
| Curative efficacy of ticagrelor combined with thrombolytic therapy for patients with ST-segment elevation myocardial infarction and its effects on level of myocardial damage markers and inflammatory factors |
| 投稿时间：2015-10-17 |
| DOI： |
| 中文关键词: 替格瑞洛 溶栓治疗 ST段抬高型心肌梗死 心肌损伤标志物 炎性因子 |
| 英文关键词: ticagrelor thrombolytic therapy ST-segment elevation myocardial infarction myocardial damage marker inflammatory factor |
| 基金项目:国家自然科学基金(No 81273878) |
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| 中文摘要: |
| 目的 探讨替格瑞洛联合溶栓治疗ST段抬高型心肌梗死(STEMI)疗效及对患者心肌损伤标志物与炎性因子水平的影响。方法 114例符合纳入标准的STEMI患者随机分为对照组57例和试验组57例。常规治疗基础上,对照组给予氯吡格雷＋尿激酶溶栓治疗,试验组给予替格瑞洛＋尿激酶溶栓治疗。2周后,观察比较两组临床疗效,心电图ST回落、超声心动图及冠脉造影状况,心肌损伤标志物,炎性因子水平及不良反应发生情况。结果 试验组的治疗总有效率为94.7%,明显高于对照组80.7%的总有效率,比较有统计学差异(P＜0.05)。试验组ST回落>50%比率显著高于对照组,LVEF显著高于对照组,LVEDd显著短于对照组,差异均具有统计学意义(P<0.05),两组TIMI 3级比率无显著统计学差异(P>0.05)。治疗后,两组患者损伤标志物CK-MB和cTnI均显著降低；对照组CK-MB和cTnI分别为(16.36±2.45)U·L-1与(1.84±0.39)μg·L-1,试验组CK-MB和cTnI分别为(12.17±2.10)U·L-1与(1.02±0.25)μg·L-1,均显著低于对照组,比较均有统计学差异(P均＜0.05)。治疗后,对照组炎性因子TNF-α和IL-6分别为(103.7±15.4)和(26.7±2.5)ng·L-1,试验组TNF-α和IL-6分别为(76.8±10.9)和(13.8±1.6)ng·L-1,均显著低于对照组,比较均有统计学差异(P均＜0.05)。治疗期间,两组患者均未出现严重不良反应。结论 替格瑞洛联合溶栓是STEMI的有效治疗方案,可以显著提高临床疗效,减轻心肌损伤和炎性反应,且不良反应轻微,临床上值得进一步研究。 |
| 英文摘要: |
| Objective To explore the curative efficacy of ticagrelor combined with thrombolytic therapy for patients with ST-segment elevation myocardial infarction (STEMI) and its effects on level of myocardial damage markers and inflammatory factors.Methods 114 cases of STEMI meeting the inclusion criteria were randomized into two groups equally. The control group was treated with clopidogrel combined with thrombolytic therapy,while the experiment group was treated with ticagrelor combined with thrombolytic therapy. After 2 weeks,the curative efficacy,level of myocardial damage markers,ST reduction of electrocardiograph (ECG),status of ultrasonic cardiogram (UCG) and thrombolysis in myocardial infarction (TIMI) grades,inflammatory factors and adverse reactions were compared.Results The experiment group had a therapeutic efficiency ratio of 94.7%,which was significantly higher than that of 80.7% in the control group (P<0.05). After treatments,the rates of ST reduction >50% and LVEF of the experimental group were significantly higher than those of the control group,the LVEDd level was significantly lower than that of the control group(P<0.05). There was no significant difference in TIMI grade 3 flow. The myocardial damage markers of CK-MB and cTnI was (16.36±2.45)U·L-1 and (1.84±0.39) μg·L-1 respectively in the control group,and (12.17±2.10) U·L-1 and (1.02±0.25) μg·L-1 respectively in the experiment group,which were all statistically lower than the former group (both P<0.05). As to inflammatory factors after treatments,levels of TNF-α and IL-6 were (103.7±15.4) and (26.7±2.5) ng·L-1 respectively in the control group,and (76.8±10.9) and (13.8±1.6) ng·L-1 respectively in the experiment group,which were all statistically lower than the former group (both P<0.05). During the treatment,there’s no case of severe adverse reaction in both groups. Conclusions Treatment of ticagrelor combined with thrombolytic therapy is effective for STEMI,which can significantly increase curative efficacy,alleviate myocardial damage and inflammatory reaction with minor adverse reactions. |
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