替格瑞洛联合比伐芦定对急性ST段抬高型心肌梗死患者急诊PCI术中无复流/慢血流的作用

目的观察替格瑞洛联合比伐芦定在急性ST段抬高型心肌梗死(STEMI)患者行急诊PCI术中无复流/慢血流的发生情况,探讨其是否有预防作用。方法回顾性分析从2015年1月1日至2016年11月30日在我院行急诊PCI的STEMI患者,按照所使用的负荷抗血小板药物及术中抗凝药物分为:A组(氯吡格雷+肝素)、B组(氯吡格雷+比伐芦定)、C组(替格瑞洛+肝素)和D组(替格瑞洛+比伐芦定),观察术中球囊扩张后或支架植入后的血流再灌注情况,TIMI血流≤2级即为无复流/慢血流。结果 D组无复流/慢血流的发生率为16.51%,明显低于其余3组(P0.01)。结论替格瑞洛联合比伐芦定能降低STEMI患者急诊PCI术中无复流/慢血流的发生率,两者或许具有协同作用。

Effect of Ticagrelor Combined with Bivalirudin for no-Reflow/slow-Reflow in ST Segment Eevation Myocardial Infarction Patients Undergoing Emergency PCI

Objective To study whether ticagrelor combined with bivalirudin can prevent the noreflow/slow-reflow in patients with ST segment elevation myocardial infarction (STEMI)and receiving emergency PCI.Methods STEMI patients received emergency PCI from January 1,2015 to November 30,2016 in our hospital were analyzedy retrospectively.The patients were divided into 4 groups according to the usage of antiplatelet drugs and anticoagulant drugs:Group A(Clopidogrel + Heparin),Group B (Clopidogrel + Bivalirudin),Group C (Ticagrelor + Heparin),Group D (Ticagrelor + Bivalirudin),the reperfusion flow was observed after balloon dilation or stenting,if TIMI flow≤2,it was defined as no-reflow/slow-reflow.Results The incidence of no-reflow/slow-reflow in Group D is 16.51％,which was significantly lower than that of other 3 groups (P ＜ 0.01).Conclusion Ticagrelor combined with bivalirudin can reduce the incidence of noreflow/slow-reflow in STEMI patients undergoing emergency PCI,they may have synergistic effect.