CAJ | 학술논문

目的：探讨新型抗栓药物替格瑞洛和比伐卢定在急性ST段抬高型心肌梗死（ STEMI）急诊PCI中早期联合应用对无复流现象的预防效果。方法选取2012年5月～2013年12月就诊于心内科且符合纳入、排除标准的患者67例作为研究对象。依据就诊顺序随机分为对照组（32例）和治疗组（35例）。对照组术前给予口服阿司匹林和氯吡格雷，术中给予肝素，治疗组术前给予阿司匹林替格瑞洛、术中给予比伐卢定治疗。于给药前和术后分别记录两组TIMI血流分级、校正的TIMI帧数（CTFC）以及无复流率。给药前，两组在一般情况和TIMI血流分级上均无统计学差异（p＞0.05），具有可比性。结果术后，治疗组的TIMI血流分级高于对照组（p＜0.05），治疗组的无复流率和CTFC较对照组低（p＜0.05）。结论对STEMI患者行急诊PCI时，早期联合应用替格瑞洛和比伐卢定能较好地预防无复流现象。
목적：탐토신형항전약물체격서락화비벌로정재급성ST단태고형심기경사（ STEMI）급진PCI중조기연합응용대무복류현상적예방효과。방법선취2012년5월～2013년12월취진우심내과차부합납입、배제표준적환자67례작위연구대상。의거취진순서수궤분위대조조（32례）화치료조（35례）。대조조술전급여구복아사필림화록필격뢰，술중급여간소，치료조술전급여아사필림체격서락、술중급여비벌로정치료。우급약전화술후분별기록량조TIMI혈류분급、교정적TIMI정수（CTFC）이급무복류솔。급약전，량조재일반정황화TIMI혈류분급상균무통계학차이（p＞0.05），구유가비성。결과술후，치료조적TIMI혈류분급고우대조조（p＜0.05），치료조적무복류솔화CTFC교대조조저（p＜0.05）。결론대STEMI환자행급진PCI시，조기연합응용체격서락화비벌로정능교호지예방무복류현상。
Objective To explore the effects of combination use of ticagrelor and bivalirudin on no -reflow phenom-enon in patients with Acute ST-Elevation Myocardial Infarction (STEMI) during percutaneous coronary intervention (PCI). Methods A total of 67 STEMI patients who received PCI during May 2012 and December 2013 were randomly divided into control group ( aspirin 300 mg and clopidogrel 600 mg taken orally before PCI) intravenous injection of Heparin 100 u/kg and treatment group (aspirin 300 mg, ticagrelor 180 mg taken orally before PCI , intravenous injection of bivalirudin 0.75 mg/kg and intravenous drip of bivalirudin 1.75 mg/( kg· h) till completing the operation.The two group had no statistical signifi-cance in all aspects before giving drugs.Results After operation, the treatment group had a higher rank of TIMI, and lower value of TCFC and lower rate of no -reflow, all P value were less than 0.05.Conclusion Early Combination use of ti-cagrelor and bivalirudin treatment during percutaneous coronary intervention in patients with Acute ST -Elevation Myocardial Infarction is beneficial to the prevention of no-reflow phenomenon.