临床误诊误治2018，Vol.31Issue(1)：78-82,5.DOI:10.3969/j.issn.1002-3429.2018.01.028
急性ST段抬高型心肌梗死术前抗栓预处理对自发再灌注及短期预后的影响
Effect of Preoperative Antithrombotic Pretreatment on Spontaneous Reperfusion and Short-term Prognosis in Pa-tients with Acute ST-segment Elevation Myocardial Infarction
摘要
Abstract
Objective To investigate the effect of antithrombotic pretreatment before percutaneous coronary interven-tion ( PCI) on spontaneous reperfusion and acute short-term prognosis of acute ST-elevation myocardial infarction ( STEMI) . Methods Retrospective analysis of January 1, 2014 to July 31, 2016, clinical data of 206 patients with acute STEMI com-bined with emergency PCI diagnosed by Cardiology of Bethune International Peace Hospital. Respectively:① According to preoperative antiplatelet pretreatment,the cases were divided into 105 cases of clopidogrel group and 101 cases of ticagrelor group,then the spontaneous reperfusion rates in both groups were compared;②On the basis of load antiplatelet pretreatment, all were divided into three groups,control group ( untreated) 84 cases, heparin group ( general heparin 70-100 U/kg) 26 ca-ses, tirofiban group ( tirofiban 10 μg/kg) 96 cases, according to preoperative antithrombotic pretreatment, then compared the spontaneous reperfusion rates of each group;③ According to the results of coronary angiography, 56 cases were divided into spontaneous reperfusion group, 150 cases were not spontaneous reperfusion group, and the effect of spontaneous reperfusion on prognosis was analyzed. Results ①The spontaneous reperfusion rate of ticagrelor group was significantly higher than clopi-dogrel group (P=0. 040);② The spontaneous reperfusion rate of heparin group and tirofiban group spontaneous reperfusion rate were significantly higher than control group (P=0. 004, P=0. 006);③ The incidence of adverse cardiac events in the spontaneous reperfusion group was significantly lower than that in the spontaneous reperfusion group (P=0. 030). The LVEF and LVID were significantly superior to those of the spontaneous reperfusion group after three months of discharge ( P =0. 000). Conclusion In patients with acute STEMI, the selection of ticagrelor antiplatelet pretreatment, once diagnosed im-mediately given heparin or preoperative application of tirofiban, all contribute to spontaneous reperfusion and can reduce the incidence of cardiac adverse events during hospitalization.关键词
心肌梗死/心肌再灌注/缺血预处理,心肌/预后Key words
Myocardial infarction/Myocardial reperfusion/Ischemic preconditioning/myocardial/Prognosis分类
医药卫生引用本文复制引用
高亚松,苏岩岩,丁超..急性ST段抬高型心肌梗死术前抗栓预处理对自发再灌注及短期预后的影响[J].临床误诊误治,2018,31(1):78-82,5.基金项目
河北省2014年医学科学研究课题(ZL20140138) （ZL20140138）
