本文關(guān)鍵詞： 急性心肌梗死 替格瑞洛 氯吡格雷 QT離散度 血小板聚集率　出處：《中國老年學(xué)雜志》2016年15期 　論文類型：期刊論文

【摘要】：目的探討行急診經(jīng)皮冠脈介入(PCI)術(shù)的急性ST段抬高性心肌梗死(STEMI)患者口服替格瑞洛對(duì)血小板聚集率及體表心電圖QT離散度(QTd)的影響及臨床意義。方法明確診斷為STEMI的患者68例隨機(jī)分為替格瑞洛組與氯吡格雷組。觀察兩組在急診PCI治療前及治療后血小板聚集率和QTd的變化。結(jié)果急診PCI治療前有22例出現(xiàn)室性心律失常,急診PCI后,無室性心律失常出現(xiàn),QTd在室性心律失常組較非室性心律失常組明顯延長(P0.05);氯吡格雷組術(shù)后2、24 h血小板聚集率較術(shù)前均明顯下降(P0.05);替格瑞洛組術(shù)后2、24 h血小板聚集率較術(shù)前均明顯下降(P0.01);與氯吡格雷組比較,替格瑞洛組術(shù)后2、24 h血小板聚集率下降更明顯(P0.05);氯吡格雷組QTd術(shù)后較術(shù)前明顯降低(P0.05),替格瑞洛組QTd術(shù)后較術(shù)前明顯降低(P0.01),與氯吡格雷組比較,替格瑞洛組下降更明顯(P0.05);住院期間替格瑞洛組與氯吡格雷組出血事件發(fā)生率無明顯差異(P0.05)。結(jié)論 STEMI患者行急診PCI術(shù)前及術(shù)后應(yīng)用替格瑞洛抗血小板治療,可更快、更強(qiáng)地抑制血小板聚集,顯著縮短QTd,減少惡性心律失常的發(fā)生率。
[Abstract]:Objective to investigate the effect of tigrilol on platelet aggregation rate and QT dispersion of surface electrocardiogram (ECG) in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing emergency percutaneous coronary intervention (PCI). Methods Sixty-eight patients with STEMI were randomly divided into two groups: tigril group and clopidogrel group. The platelet aggregation rate and QTd were observed before and after emergency PCI treatment. Results there were 22 cases of ventricular arrhythmia before emergency PCI treatment. After emergency PCI, no ventricular arrhythmia appeared QTD in the ventricular arrhythmia group than in the non-ventricular arrhythmia group significantly longer than the non-ventricular arrhythmia group. In clopidogrel group, the platelet aggregation rate at 24 h after operation was significantly lower than that before operation (P 0.05). The platelet aggregation rate at 24 h after operation in tigrilol group was significantly lower than that before operation (P 0.01). Compared with clopidogrel group, the platelet aggregation rate of tigrilol group decreased more significantly than that of clopidogrel group at 24 h after operation (P 0.05). Compared with clopidogrel group, clopidogrel group was significantly lower than that of preoperation in QTd group (P 0.05) and tigrilol group (P 0.01) after QTd operation, which was significantly lower than that in clopidogrel group. In tigrilol group, the decrease was more obvious than that in the control group (P 0.05). There was no significant difference in the incidence of bleeding events between the tigrilol group and clopidogrel group during hospitalization P0.05Conclusion the patients with STEMI were treated with tigrello antiplatelet therapy before and after emergency PCI. It can inhibit platelet aggregation more quickly, shorten QTD significantly, and reduce the incidence of malignant arrhythmia.
【作者單位】： 佳木斯市中心醫(yī)院心內(nèi)科;深圳市第十人民醫(yī)院心內(nèi)科;佳木斯大學(xué)基礎(chǔ)醫(yī)學(xué)院;
【基金】：國家自然科學(xué)基金面上項(xiàng)目(No.81272854) 黑龍江省自然科學(xué)基金項(xiàng)目(No.D201129)
【分類號(hào)】：R542.22
【正文快照】： 血小板的激活、聚集、黏附是急性ST段抬高型心肌梗死(STEMI)發(fā)生的始動(dòng)因素和發(fā)展的關(guān)鍵環(huán)節(jié)。急診經(jīng)皮冠狀動(dòng)脈介入(PCI)是治療STEMI的最主要手段,急診冠脈PCI可開通阻塞冠脈血管,及時(shí)恢復(fù)心肌血流灌注,是目前首選的再灌注治療策略。我國最新版的《STEMI診斷和治療指南》中指

【參考文獻(xiàn)】

相關(guān)期刊論文 前4條

1 萬明勇;鄭春華;鄒思紋;;急性心肌梗死患者PCI前后QT離散度和心率變異性的比較[J];臨床和實(shí)驗(yàn)醫(yī)學(xué)雜志;2015年16期

2 ;急性ST段抬高型心肌梗死診斷和治療指南[J];中華心血管病雜志;2010年08期

3 鐘偉濟(jì);左京生;;HRV及QTd在急性心肌梗死早期溶栓治療中的意義[J];中國現(xiàn)代醫(yī)生;2009年35期

4 楊秀春,都軍,崔煒,劉凡,祖秀光,李擁軍,郝玉明,謝瑞芹;經(jīng)皮冠狀動(dòng)脈介入術(shù)對(duì)冠心病患者的QT離散度心率變異性和心室晚電位的影響[J];臨床心血管病雜志;2003年11期

【共引文獻(xiàn)】

相關(guān)期刊論文 前10條

1 張琴;楊蘇萍;張雅莉;洪基格;陳曉婕;田曉芬;吳潔;;城市社區(qū)醫(yī)護(hù)人員心電圖知識(shí)和技能現(xiàn)狀調(diào)查及培訓(xùn)效果觀察[J];中國臨床新醫(yī)學(xué);2016年08期

2 路宗全;;心肌梗死三項(xiàng)聯(lián)檢在急性ST段抬高型心肌梗死診斷中的應(yīng)用分析[J];首都食品與醫(yī)藥;2016年16期

3 田鳳芹;;麝香保心丸聯(lián)合尿激酶治療急性心肌梗死抗過氧化損傷作用研究[J];現(xiàn)代中西醫(yī)結(jié)合雜志;2016年23期

4 張明亮;沈玉華;張立敏;李大鵬;殷實(shí);李s，

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