比伐卢定联合替格瑞洛治疗ST段抬高型心肌梗死患者的临床研究

　　[摘要] 目的 探討比伐卢定联合替格瑞洛治疗老年ST段抬高型心肌梗死（ST-segment elevation myocardial infarction，STEMI）患者的临床疗效。方法 回顾性分析2016年6月～2017年9月在我院住院的140例老年（年龄≥60）行直接经皮冠状动脉介入（primary percutaneous coronary intervention，PPCI）治疗的STEMI患者，分为两组，观察组68例，术前阿司匹林联合替格瑞洛治疗，术中比伐卢定抗凝；对照组72例， 术前阿司匹林联合氯吡格雷治疗，术中肝素钠抗凝。结果 PPCI治疗后观察组心肌梗死溶栓试验（Thrombolysis in Myocardial Infarction，TIMI）血流分级TIMI3级比率高于对照组，差异有统计学意义（P<0.05）。随访1个月，主要不良心血管事件（major adverse cardiovascular events，MACE）发生率观察组（1.47%）较对照组 （11.11%）降低，差异有统计学意义（P<0.05）。出血发生率观察组（1.4%）较对照组（5.6%）降低，差异无统计学意义（P>0.05）。结论 比伐卢定联合替格瑞洛和阿司匹林的抗栓治疗方案可以改善老年STEMI患者预后。
　　[关键词] 替格瑞洛；氯吡格雷；经皮冠状动脉介入治疗；急性 ST 段抬高型心肌梗死
　　[中图分类号] R542.22 [文献标识码] B [文章编号] 1673-9701（2018）08-0045-04
　　Clinical study of bivalirudin combined with ticagrelor in patients with ST - elevation myocardial infarction
　　JIANG Yang ZHENG Xiaoqun
　　Ward 4 of Department of Cardiology， Dalian Municipal Central Hospital， Dalian 116000，China
　　[Abstract] Objective To investigate the clinical effect of bivalirudin combined with ticagrelor on elderly patients with ST-segment elevation myocardial infarction（STEMI）. Methods A retrospective analysis of 140 elderly （≥60 years） STEMI （segment elevation myocardial infarction）patients undergoing primary percutaneous coronary intervention （PPCI） hospitalized in Dalian Central Hospital from June 2016 to September 2017 was conducted. For the two groups， 68 cases in the observation group took preoperative aspirin combined with ticagrelor and intraoperative bivalirudin anticoagulation treatment； 72 patients in control group took preoperative aspirin combined with clopidogrel and intraoperative heparin sodium coagulation treatment. Results The rate of TIMI grade 3（Thrombolysis in Myocardial Infarction，TIMI） in observation group after PPCI treatment was higher than that of control group， the difference was statistically significant （P<0.05）. One month after follow-up， the incidence of major adverse cardiovascular events（MACE） in observation group （1.47%） was lower than that in control group（11.11%）， the difference was statistically significant（P<0.05）. The incidence of bleeding in the observation group （1.4%） was lower than that in the control group （5.6%）， with no significant difference（P>0.05）. Conclusion The antithrombotic regimen of bivalirudin combined with ticagrelor and aspirin can improve the prognosis of elderly patients with STEMI.
　　[Key words] Ticagrelor； Clopidogrel； Percutaneous coronary intervention； Acute ST-segment elevation myocardial infarction；

相关热词搜索：心肌梗死 抬高 临床研究 患者 治疗