替格瑞洛对STEMI行急诊PCI后心肌血流灌注的影响观察(1)
【摘要】 目的 探討替格瑞洛对急性ST 段抬高型心肌梗死(STEMI)行急诊经皮冠状动脉介入治疗(PCI)后心肌血流灌注的影响， 为心肌梗死的急救治疗提供参考。方法 160例发病12 h 内行急诊PCI治疗的STEMI患者， 采用随机信封法分为A组(85例)与B组(75例)。A 组患者术前给予阿司匹林
300 mg负荷剂量和氯吡格雷600 mg负荷剂量口服， B组患者术前给予阿司匹林300 mg负荷剂量和替格瑞洛180 mg负荷剂量口服。比较两组患者术前、术后即刻TIMI血流分级， 术后校正TIMI计帧数(cTFC)。结果 术前， 两组患者TIMI血流分级比较差异无统计学意义(Z=0.819， P>0.05);术后即刻， 两组患者TIMI血流分级比较差异无统计学意义(Z=1.732， P>0.05)。术后， B组患者cTFC为(26.2±7.7)帧， 低于
A组的(39.6 ±6.1)帧， 差异具有统计学意义(t=12.266， P<0.05)。结论 对于STEMI 患者， 急诊PCI术前给予负荷量替格瑞洛强化抗血小板治疗， 可减少围手术期无复流发生， 有效改善心肌血流灌注， 降低心脏不良事件发生率
【关键词】 替格瑞洛;急性ST 段抬高型心肌梗死;经皮冠状动脉介入治疗;TIMI计帧数
DOI：10.14163/j.cnki.11-5547/r.2019.33.046
Observation on effect of tegrarol on myocardial perfusion after emergency PCI in STEMI WANG Xin， AN Jian. Shanxi Cardiovascular Hospital， Taiyuan 030024， China
【Abstract】 Objective To discuss the effect of tegrarol on myocardial perfusion after emergency percutaneous coronary intervention (PCI) in ST-segment elevation myocardial infarction (STEMI)， so as to provide reference for emergency treatment of myocardial infarction. Methods A total of 160 STEMI patients who were treated with PCI within 12 h after onset were divided into group A (85 cases) and group B (75 cases) by envelope method. Group A received loading dose of aspirin 300 mg and clopidogrel 600 mg by oral administration， and group B received loading dose of aspirin 300 mg and tegrarol 180 mg by oral administration. The TIMI blood flow classification before operation and immediately after operation and corrected TIMI frame count (cTFC) after operation was compared between the two groups. Results Before treatment， there was no statistically significant difference in TIMI blood flow classification (Z=0.819， P>0.05). Immediately after operation， there was no statistically significant difference in TIMI blood flow classification (Z=1.732， P>0.05). After operation， the cTFC was (26.2±7.7) frames in group B， which was lower than (39.6 ±6.1) frames in group A， and the difference was statistically significant (t=12.266， P<0.05). Conclusion For STEMI patients， intensive antiplatelet therapy with loading dose of tigralol before emergency PCI can reduce the occurrence of no reflow in perioperative period， effectively improve myocardial perfusion and reduce the incidence of adverse cardiac events.
【Key words】 Tegrarol; Acute ST-segment elevation myocardial infarction; Percutaneous coronary intervention; TIMI frame count, 百拇医药(王馨 安健)
300 mg负荷剂量和氯吡格雷600 mg负荷剂量口服， B组患者术前给予阿司匹林300 mg负荷剂量和替格瑞洛180 mg负荷剂量口服。比较两组患者术前、术后即刻TIMI血流分级， 术后校正TIMI计帧数(cTFC)。结果 术前， 两组患者TIMI血流分级比较差异无统计学意义(Z=0.819， P>0.05);术后即刻， 两组患者TIMI血流分级比较差异无统计学意义(Z=1.732， P>0.05)。术后， B组患者cTFC为(26.2±7.7)帧， 低于
A组的(39.6 ±6.1)帧， 差异具有统计学意义(t=12.266， P<0.05)。结论 对于STEMI 患者， 急诊PCI术前给予负荷量替格瑞洛强化抗血小板治疗， 可减少围手术期无复流发生， 有效改善心肌血流灌注， 降低心脏不良事件发生率
【关键词】 替格瑞洛;急性ST 段抬高型心肌梗死;经皮冠状动脉介入治疗;TIMI计帧数
DOI：10.14163/j.cnki.11-5547/r.2019.33.046
Observation on effect of tegrarol on myocardial perfusion after emergency PCI in STEMI WANG Xin， AN Jian. Shanxi Cardiovascular Hospital， Taiyuan 030024， China
【Abstract】 Objective To discuss the effect of tegrarol on myocardial perfusion after emergency percutaneous coronary intervention (PCI) in ST-segment elevation myocardial infarction (STEMI)， so as to provide reference for emergency treatment of myocardial infarction. Methods A total of 160 STEMI patients who were treated with PCI within 12 h after onset were divided into group A (85 cases) and group B (75 cases) by envelope method. Group A received loading dose of aspirin 300 mg and clopidogrel 600 mg by oral administration， and group B received loading dose of aspirin 300 mg and tegrarol 180 mg by oral administration. The TIMI blood flow classification before operation and immediately after operation and corrected TIMI frame count (cTFC) after operation was compared between the two groups. Results Before treatment， there was no statistically significant difference in TIMI blood flow classification (Z=0.819， P>0.05). Immediately after operation， there was no statistically significant difference in TIMI blood flow classification (Z=1.732， P>0.05). After operation， the cTFC was (26.2±7.7) frames in group B， which was lower than (39.6 ±6.1) frames in group A， and the difference was statistically significant (t=12.266， P<0.05). Conclusion For STEMI patients， intensive antiplatelet therapy with loading dose of tigralol before emergency PCI can reduce the occurrence of no reflow in perioperative period， effectively improve myocardial perfusion and reduce the incidence of adverse cardiac events.
【Key words】 Tegrarol; Acute ST-segment elevation myocardial infarction; Percutaneous coronary intervention; TIMI frame count, 百拇医药(王馨 安健)