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目的观察ST段抬高型心肌梗死患者经皮冠状动脉介入治疗术(PCI)后应用替格瑞洛与氯吡格雷的临床疗效。方法住院接受PCI治疗的ST段抬高型心肌梗死患者231例,随机分为试验组121例与对照组110例。试验组在PCI治疗前口服替格瑞洛,起始剂量为单次负荷剂量180 mg;此后,每次90 mg,每天2次;对照组在PCI治疗前口服氯吡格雷300 mg,此后口服75 mg·d~(-1)维持。2组均治疗30 d。患者在PCI前后进行心肌梗死溶栓治疗血流分级,治疗前、治疗后30 d进行超声检查评价患者的左心功能,统计术后1个月心血管事件的发生率。结果 2组患者在术前、术后的心肌梗死溶栓治疗血流分级差异无统计学意义(P>0.05)。治疗后,2组患者心功能改善显著优于治疗前(P<0.05);试验组心血管事件发生率(8.3%)显著低于对照组(19.1%,P<0.05)。结论 ST段抬高型心肌梗死患者PCI术后应用替格瑞洛可以有效减少心血管事件的发生率,促进左心功能恢复,安全性较好。
Objective To observe the clinical effect of ticagrelor and clopidogrel after percutaneous coronary intervention (PCI) in patients with ST segment elevation myocardial infarction. Methods A total of 231 hospitalized patients with ST-elevation myocardial infarction treated with PCI were randomly divided into experimental group (n = 121) and control group (n = 110). The test group was given ticagrelor orally before PCI, and the initial dose was 180 mg once. The control group received clopidogrel 300 mg orally once a day before treatment with 90 mg twice daily. mg · d ~ (-1) maintenance. Both groups were treated for 30 days. Before and after PCI in patients with myocardial infarction thrombolytic therapy of blood flow grading, before treatment, 30 d after treatment for assessment of left ventricular function in patients with ultrasound, statistics 1 month after the incidence of cardiovascular events. Results There was no significant difference in the grade of thrombolysis between preoperative and postoperative myocardial infarction in the two groups (P> 0.05). After treatment, the improvement of cardiac function in the two groups was significantly better than that before treatment (P <0.05). The incidence of cardiovascular events in the experimental group (8.3%) was significantly lower than that in the control group (19.1%, P <0.05). Conclusion The application of ticagrelor in patients with ST-segment elevation myocardial infarction after PCI can effectively reduce the incidence of cardiovascular events and promote the recovery of left ventricular function, which is safe.