[摘要] 目的 探討比伐盧定聯(lián)合替格瑞洛治療老年ST段抬高型心肌梗死（ST-segment elevation myocardial infarction，STEMI）患者的臨床療效。方法 回顧性分析2016年6月～2017年9月在我院住院的140例老年（年齡≥60）行直接經(jīng)皮冠狀動(dòng)脈介入（primary percutaneous coronary intervention，PPCI）治療的STEMI患者，分為兩組，觀察組68例，術(shù)前阿司匹林聯(lián)合替格瑞洛治療，術(shù)中比伐盧定抗凝；對(duì)照組72例， 術(shù)前阿司匹林聯(lián)合氯吡格雷治療，術(shù)中肝素鈉抗凝。結(jié)果 PPCI治療后觀察組心肌梗死溶栓試驗(yàn)（Thrombolysis in Myocardial Infarction，TIMI）血流分級(jí)TIMI3級(jí)比率高于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。隨訪1個(gè)月，主要不良心血管事件（major adverse cardiovascular events，MACE）發(fā)生率觀察組（1.47%）較對(duì)照組 （11.11%）降低，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。出血發(fā)生率觀察組（1.4%）較對(duì)照組（5.6%）降低，差異無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05）。結(jié)論 比伐盧定聯(lián)合替格瑞洛和阿司匹林的抗栓治療方案可以改善老年STEMI患者預(yù)后。
　　[關(guān)鍵詞] 替格瑞洛；氯吡格雷；經(jīng)皮冠狀動(dòng)脈介入治療；急性 ST 段抬高型心肌梗死
　　[中圖分類號(hào)] R542.22 [文獻(xiàn)標(biāo)識(shí)碼] B [文章編號(hào)] 1673-9701（2018）08-0045-04
　　Clinical study of bivalirudin combined with ticagrelor in patients with ST - elevation myocardial infarction
　　JIANG Yang ZHENG Xiaoqun
　　Ward 4 of Department of Cardiology， Dalian Municipal Central Hospital， Dalian 116000，China
　　[Abstract] Objective To investigate the clinical effect of bivalirudin combined with ticagrelor on elderly patients with ST-segment elevation myocardial infarction（STEMI）. Methods A retrospective analysis of 140 elderly （≥60 years） STEMI （segment elevation myocardial infarction）patients undergoing primary percutaneous coronary intervention （PPCI） hospitalized in Dalian Central Hospital from June 2016 to September 2017 was conducted. For the two groups， 68 cases in the observation group took preoperative aspirin combined with ticagrelor and intraoperative bivalirudin anticoagulation treatment； 72 patients in control group took preoperative aspirin combined with clopidogrel and intraoperative heparin sodium coagulation treatment. Results The rate of TIMI grade 3（Thrombolysis in Myocardial Infarction，TIMI） in observation group after PPCI treatment was higher than that of control group， the difference was statistically significant （P<0.05）. One month after follow-up， the incidence of major adverse cardiovascular events（MACE） in observation group （1.47%） was lower than that in control group（11.11%）， the difference was statistically significant（P<0.05）. The incidence of bleeding in the observation group （1.4%） was lower than that in the control group （5.6%）， with no significant difference（P>0.05）. Conclusion The antithrombotic regimen of bivalirudin combined with ticagrelor and aspirin can improve the prognosis of elderly patients with STEMI.
　　[Key words] Ticagrelor； Clopidogrel； Percutaneous coronary intervention； Acute ST-segment elevation myocardial infarction；

相關(guān)熱詞搜索：心肌梗死 抬高 臨床研究 患者 治療