替格瑞洛联合PCI治疗老年急性心肌梗死对患者氧化应激损伤心功能及不良心血管事件发生的影响

doi:10.3969/j.issn.1006-6233.2024.04.011

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摘要 目的: 观察替格瑞洛联合经皮冠状动脉介入(PCI)治疗老年急性心肌梗死对患者氧化应激损伤、心功能及不良心血管事件发生的影响。方法: 选取2020年1月至2021年6月在我院行PCI治疗的160例老年急性心肌梗死患者为研究对象,采用随机数字表法分为两组,单组80例。两组均给予PCI治疗,对照组给予阿司匹林联合氯吡格雷双联抗血小板治疗,观察组给予阿司匹林联合替格瑞洛抗血小板治疗。比较两组心功能、氧化应激损伤、高敏-C反应蛋白(hs-CRP)、可溶性CD40配体(sCD40L)、氨基末端脑钠肽前体(NT-proBNP)、活化血小板糖基化复合物(PAC-1)的差异,统计两组主要不良心血管事件(MACE)发生情况。结果: 治疗前,两组心功能比较,差异无统计学意义(P>0.05)。与治疗前比较,两组治疗4周、24周左室射血分数(LVEF)、每搏量(SV)、心脏指数(CI)均升高,两组组间心功能比较,差异无统计学意义(P>0.05)。治疗前,两组氧化应激损伤指标及hs-CRP、NT-proBNP、sCD40L、PAC-1比较,差异无统计学意义(P>0.05)。与治疗前比较,两组治疗4周、24周hs-CRP、NT-proBNP、丙二醛(MDA)、sCD40L、PAC-1均下降,观察组治疗4周、24周低于对照组(P<0.05),两组治疗4周、24周超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)均升高,观察组治疗4周、24周高于对照组(P<0.05)。观察组MACE发生率为7.50%(6/80)低于对照组的18.75%(15/80)(P<0.05),累计不良反应发生率为13.75%(11/80)与对照组的11.25%(9/80)比较,差异无统计学意义(P>0.05)。结论: 替格瑞洛联合PCI治疗老年急性心肌梗死可减轻患者氧化应激损伤,降低hs-CRP、NT-proBNP等表达水平,减少MACE的发生。

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	吴路路
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关键词 ：急性心肌梗死, 替格瑞洛, 经皮冠状动脉介入, 氧化应激损伤, 不良心血管事件

Abstract：Objective: To observe the effects of Ticagrelor combined with percutaneous coronary intervention (PCI) on oxidative stress injury, cardiac function and adverse cardiovascular events in elderly patients with acute myocardial infarction. Methods: A total of 160 elderly patients with acute myocardial infarction who underwent PCI treatment in our hospital from January 2020 to June 2021 were selected as the study subjects. They were randomly divided into two groups using a random number table method, with a single group of 80 patients. Both groups received PCI treatment, the control group received dual antiplatelet therapy of aspirin combined with clopidogrel, and the observation group received antiplatelet therapy of aspirin combined with tigrel. Compare the differences in cardiac function, oxidative stress injury, high sensitivity C-reactive protein (hs CRP), soluble CD40 ligand (sCD40L), N-terminal proBNP precursor (NT-proBNP), and activated platelet glycosylation complex (PAC-1) between the two groups, and analyze the occurrence of major adverse cardiovascular events (MACE) between the two groups. Results: Before treatment, there was no statistically significant difference in cardiac function between the two groups (P>0.05). Compared with before treatment, the left ventricular ejection fraction (LVEF), stroke volume (SV), and cardiac index (CI) of the two groups increased at 4 and 24 weeks of treatment. There was no statistically significant difference in cardiac function between the two groups (P>0.05). Before treatment, there was no statistically significant difference in the indicators of oxidative stress damage, hs CRP, NT-proBNP, sCD40L, and PAC-1 between the two groups (P>0.05). Compared with before treatment, hs CRP, NT-proBNP, malondialdehyde (MDA), sCD40L, and PAC-1 in both groups decreased at 4 and 24 weeks of treatment. The observation group was lower than the control group at 4 and 24 weeks of treatment (P<0.05), and the levels of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) in both groups increased at 4 and 24 weeks of treatment. The observation group was higher than the control group at 4 and 24 weeks of treatment (P<0.05). The incidence of MACE in the observation group was 7.50% (6/80), lower than the control group's 18.75% (15/80) (P<0.05), and the cumulative incidence of adverse reactions was 13.75% (11/80). There was no statistically significant difference (P>0.05) compared to the control group's 11.25% (9/80). Conclusion: Tiagrelor combined with PCI in the treatment of elderly patients with acute myocardial infarction can reduce oxidative stress injury, reduce the expression levels of hs-CRP and NT-proBNP, and reduce the occurrence of MACE.

Key words： Acute myocardial infarction Ticagrelor Percutaneous coronary intervention Oxidative stress injury Adverse cardiovascular events

基金资助:山西省卫生健康委科研项目,(编号:2021157)

通讯作者: 苗鹏飞

引用本文:

吴路路, 史生金, 李嘉伟, 苗鹏飞. 替格瑞洛联合PCI治疗老年急性心肌梗死对患者氧化应激损伤心功能及不良心血管事件发生的影响[J]. 河北医学, 2024, 30(4): 586-592.
WU Lulu, SHI Shengjin, LI Jiawei, et al. Effects of Ticagrelor Combined with PCI on Oxidative Stress Injury Cardiac Function and Adverse Cardiovascular Events in Elderly Patients with Acute Myocardial Infarction. HeBei Med, 2024, 30(4): 586-592.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2024.04.011 或 http://www.hbyxzzs.cn/CN/Y2024/V30/I4/586

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