替格瑞洛联合尿激酶原与瑞替普酶溶栓对STEMI患者心功能和血液相关指标的影响和安全性研究

doi:10.5246/jcps.2024.12.082

中国药学(英文版) ›› 2024, Vol. 33 ›› Issue (12): 1129-1136.DOI: 10.5246/jcps.2024.12.082

替格瑞洛联合尿激酶原与瑞替普酶溶栓对STEMI患者心功能和血液相关指标的影响和安全性研究

王冬娟, 陈继红^*()

山西中条山集团总医院心内科, 山西 043700

收稿日期:2024-07-21 修回日期:2024-08-19 接受日期:2024-10-12 出版日期:2025-01-07 发布日期:2025-01-06
通讯作者: 陈继红

Enhancing cardiac function and hematological parameters in STEMI patients: evaluating the efficacy and safety of ticagrelor combined with prourokinase and reteplase thrombolysis

Dongjuan Wang, Jihong Chen^*()

Hospital of Shanxi Zhongtiaoshan Group General, Shanxi 043700, China

Received:2024-07-21 Revised:2024-08-19 Accepted:2024-10-12 Online:2025-01-07 Published:2025-01-06
Contact: Jihong Chen

摘要/Abstract

摘要：

本研究旨在比较替格瑞洛联合尿激酶原与瑞替普酶溶栓对ST段抬高型心肌梗死(STEMI)患者心功能和血液相关指标的影响和安全性研究。按照随机数字表法原则将收集的2017年1月到2021年12月我院280例STEMI患者分为试验组和对照组, 各140例。对照组采用替格瑞洛联合尿激酶原溶栓治疗, 试验组采用替格瑞洛联合瑞替普酶溶栓治疗, 比较两组治疗对STEMI患者心功能和血液相关指标的影响及不良事件发生率。结果显示治疗7天后, 两组CK-MB、AST、LDH明显低于治疗前, 且试验组明显低于对照组; 在治疗24小时后NT-proBNP水平下降, 且试验组明显低于对照组; 7天LVEF和E/A值均明显升高; LVEDd和LVESd值均明显减少, 且试验组心功能水平高于对照组; 治疗7天后两组的PT、TT和APTT水平显著升高, FIB水平显著降低, 且两组差异显著; 治疗后试验组MACE事件总发生率明显低于对照组, 但轻度出血率没有明显差异。说明采用替格瑞洛联合瑞替普酶能更有效地降低患者心肌酶和NT-proBNP水平, 且有效改善心功能和提高安全性。总体来说, 替格瑞洛联合瑞替普酶综合效果更优, 值得临床推广。

关键词: ST段抬高型心肌梗死, 溶栓, 心功能, 替格瑞洛, 尿激酶原, 瑞替普酶

Abstract:

To compare the effects of ticagrelor combined with prourokinase and reteplase thrombolysis on cardiac function and blood-related indexes in patients with ST-segment elevation myocardial infarction (STEMI), 280 patients hospitalized between January 2017 and December 2021 were randomly assigned into two groups: the experimental group and the control group, each comprising 140 cases. The control group received ticagrelor combined with prourokinase thrombolysis, while the experimental group received ticagrelor combined with reteplase thrombolysis. The impact of these treatments on cardiac function and blood-related indexes in STEMI patients was assessed. Results revealed that CK-MB, AST, and LDH levels significantly decreased after 7 d of treatment compared to pre-treatment levels, with the experimental group exhibiting lower levels compared to the control group. Additionally, NT-proBNP levels decreased in both groups after 24 h of treatment, with the experimental group showing a greater reduction compared to the control group. Furthermore, LVEF and E/A values significantly increased after 7 d of treatment in both groups, while LVEDd and LVESd values notably decreased, indicating improved cardiac function in the experimental group compared to the control group. Following treatment, levels of PT, TT, and APTT increased in both groups, while FIB levels decreased significantly, with noticeable differences between the two groups. The incidence of major adverse cardiovascular events (MACE) in the experimental group was significantly lower compared to the control group, although the rate of mild bleeding did not significantly differ. In conclusion, the combination of ticagrelor and reteplase demonstrated superior efficacy in reducing myocardial enzyme and NT-proBNP levels, improving cardiac function, and enhancing safety compared to ticagrelor and prourokinase. These findings suggested that ticagrelor combined with reteplase thrombolysis held promise for clinical application.

Key words: ST segment elevation myocardial infarction, Thrombolysis, Cardiac function, Ticagrelor, Prourokinase, Reteplase

Supporting:

王冬娟, 陈继红. 替格瑞洛联合尿激酶原与瑞替普酶溶栓对STEMI患者心功能和血液相关指标的影响和安全性研究[J]. 中国药学(英文版), 2024, 33(12): 1129-1136.

Dongjuan Wang, Jihong Chen. Enhancing cardiac function and hematological parameters in STEMI patients: evaluating the efficacy and safety of ticagrelor combined with prourokinase and reteplase thrombolysis[J]. Journal of Chinese Pharmaceutical Sciences, 2024, 33(12): 1129-1136.

图/表 6

Table 1. Comparison of general information between two groups (x ± s, %).

Table 2. Comparison of CK-MB, AST, and LDH levels between two groups before and after treatment (x ± s, U/L).

Table 3. Comparison of NT proBNP levels between two groups before and after treatment (pg/mL, x ± s).

Table 4. Comparison of cardiac function between two groups before and after treatment (x ± s, n = 140).

Table 5. Comparison of four coagulation results between two groups before and after treatment (x ± s, n = 140).

Table 6. Comparison of incidence of adverse events between two groups after treatment (x ± s, n = 140).

参考文献 17

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替格瑞洛联合尿激酶原与瑞替普酶溶栓对STEMI患者心功能和血液相关指标的影响和安全性研究

Enhancing cardiac function and hematological parameters in STEMI patients: evaluating the efficacy and safety of ticagrelor combined with prourokinase and reteplase thrombolysis

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