替格瑞洛在氯吡格雷抵抗AMI患者PCI术后抗血小板治疗中的应用

目的 分析替格瑞洛在氯吡格雷抵抗急性心肌梗死（AMI）患者PCI术后抗血小板中的应用效果。方法 选取2018年2月~2019年2月在我院治疗的符合氯吡格雷抵抗标准的60例急性心肌梗死PCI术后患者为研究对象，采用随机数字表法分为对照组和观察组，各30例。对照组PCI术前加服氯吡格雷，术后高剂量维持，观察组术前加服替格瑞洛，术后常规剂量维持，比较两组不同时间段（术前、术后2、24、48 h）血小板聚集率、血清谷草转氨酶（AST）、血肌酐（Scr）及临床不良反应（心率衰竭、脑血管意外、心绞痛、脑缺血发作）发生情况。结果 两组术前血小板聚集率比较，差异无统计学意义（P＞0.05），观察组术后2、24、48 h血小板聚集率均低于对照组（P＜0.05）；术后两组AST、Scr均高于术前，且观察组高于对照组（P＜0.05）；术后观察组不良反应发生率（6.67%）低于对照组（26.67%），差异有统计学意义（P＜0.05）。结论 替格瑞洛治疗符合氯吡格雷抵抗标准的急性心肌梗死PCI术患者疗效确切，可降低血小板聚集率，减少肝肾损害，且不良反应少，具有较高的临床应用价值。

Application of Ticagrelor in the Antiplatelet Therapy of Clopidogrel in Patients with AMI after PCI

Objective To analyze the effect of clopidogrel on anti-platelet therapy after PCI in patients with acute myocardial infarction(AMI)with ticagrelor.Methods A total of 60 patients with acute myocardial infarction after PCI who were treated with clopidogrel resistance in our hospital from February 2018 to February 2019 were selected as the research subjects. They were divided into a control group and an observation group by random number table, each 30 example. The control group received clopidogrel before PCI and maintained a high dose after surgery. The observation group received ticagrelor before surgery and maintained a regular dose after surgery.The platelet aggregation rate, serum glutamic oxaloacetic transaminase (AST), serum creatinine (Scr) and clinical adverse reactions (heart rate failure, cerebral vascular accident, angina pectoris, ischemic attack) were compared between the two groups at different time points (before operation, 2, 24 and 48 h after operation).Results There was no significant difference in the platelet aggregation rate between the two groups before surgery (P>0.05). The platelet aggregation rate in the observation group was lower than that in the control group at 2, 24, and 48 h after surgery(P<0.05). The postoperative AST and Scr in the two groups were higher than before the operation, and the observation group was higher than the control group(P<0.05); the incidence of adverse reactions in the observation group was 6.67% lower than that in the control group 26.67%(P<0.05).Conclusion Ticagrelor is effective in treating patients with acute myocardial infarction and PCI following clopidogrel resistance. It can reduce platelet aggregation rate, reduce liver and kidney damage, and has fewer adverse reactions. It has high clinical application value.