比伐芦定联合替格瑞洛对老年STEMI患者PCI治疗的疗效及安全性分析

目的:观察比伐芦定联合替格瑞洛对老年ST段抬高型心肌梗死(STEMI)患者行经皮冠脉介入治疗(PCI)的疗效及安全性。方法:2017年1月至2018年11月在我院急诊行PCI治疗的STEMI患者134例被随机均分为对照组(接受普通肝素和替罗非班)和观察组(接受替格瑞洛和比伐芦定),两组均在造影前口服阿司匹林的基础上接受相应药物治疗。观察比较两组术后TIMI血流分级、术后72h内出血情况和术后30d内主要不良心血管事件(MACE)发生情况。结果:与对照组比较,观察组PCI术后梗死相关动脉TIMI血流3级比例(65.7%比82.1%)显著升高,术后72h内出血发生率(22.4%比9.0%)和术后30d内MACE发生率(23.9%比10.5%)显著降低,P均<0.05。结论:比伐芦定联合替格瑞洛可以显著改善老年STEMI患者PCI术后冠脉血流,且出血事件和主要不良心血管发生率低,值得推广。

Therapeutic effect of bivalirudin combined ticagrelor on aged STEMI patients undergoing PCI and its safety

Objective:To observe therapeutic effect of bivalirudin combined ticagrelor on aged patients with ST elevation myocardial infarction(STEMI)undergoing percutaneous coronary intervention(PCI)and its safety.Methods:A total of 134 STEMI patients,who received emergency PCI in our hospital from Jan 2017 to Nov 2018,were randomly and equally divided into control group(received unfractionated heparin and tirofiban)and observation group(received ticagrelor and bivalirudin),both groups received corresponding medication based on oral aspirin before coronary angiography.Postoperative TIMI blood flow grade,hemorrhage within 72h after PCI and incidence of major adverse cardiovascular events(MACE)within 30d after PCI were observed and compared between two groups.Results:Compared with control group,there was significant rise in percentage of infarct related artery TIMI flow grade 3(65.7%vs.82.1%)after PCI,and significant reductions in incidence rates of hemorrhage(22.4%vs.9.0%)within 72h after PCI and MACE(23.9%vs.10.5%)within 30 d after PCI in observation group,P<0.05 all.Conclusion:Bivalirudin combined ticagrelor can significantly improve coronary blood flow after PCI in aged STEMI patients,and its incidence rates of hemorrhage and MACE are significantly lower,which is worth extending.