内科

目的探讨替格瑞洛对急性ST段抬高型心肌梗死患者经皮冠状动脉介入治疗（PCI）术后冠状动脉血流及不良心血管事件发生的影响。方法选取2018年10月至2019年9月我院收治的急性ST段抬高型心肌梗死患者120例为研究对象，采用随机数字法分为对照组和观察组，每组60例。两组患者均给予PCI术治疗。对照组给予氯吡格雷片治疗，观察组患者给予替格瑞洛片治疗，术后持续治疗6个月。比较两组患者PCI术后的冠状动脉血流TIMI分级、矫正TIMI血流帧数计数（cTFC）、无复流情况以及冠脉开通时间、不良心血管事件发生情况。结果观察组患者术后TIMI分级高于对照组，术后cTFC、无复流比例低于对照组，差异有统计学意义（P＜0.05）。对照组50例复流患者（10例无复流）的血管开通时间为（8.32±1.25）h；观察组57例复流患者（3例无复流）的血管开通时间为（8.10±1.21）h，两组比较差异无统计学意义（P＞0.05）。术后6个月，观察组患者的不良心血管事件发生率（6.7%）显著低于对照组（20.0%），差异有统计学意义（P＜0.05）。结论进行PCI术治疗的急性ST段抬高型心肌梗死患者，使用替格瑞洛治疗能够有效改善其术后的冠状动脉血流状况，减少无复流现象发生，降低不良心血管事件发生率，值得推广应用。

ObjectiveTo explore the effect of ticagrelor on coronary blood flow and adverse cardiovascular events in patients with acute ST-segment elevation myocardial infarction after percutaneous coronary intervention (PCI). MethodsA total of 120 patients with acute ST-segment elevation myocardial infarction admitted to our hospital from October 2018 to September 2019 were selected as the research objects, and they were divided into control group and observation group by the random number method, with 60 cases in each group. Patients in both groups were treated with PCI. The control group was treated with clopidogrel tablets, and the observation group was treated with ticagrelor tablets, for a six-month treatment course after PCI. The TIMI classification of coronary artery blood flow, corrected TIMI frame count (cTFC), no-reflow, coronary recanalization time, and occurrence of adverse cardiovascular events were compared between the two groups after PCI. ResultsThe observation group yielded a higher postoperative TIMI classification, whereas lower postoperative cTFC, and proportion of no-reflow as compared with the control group, with statistically significant differences (P＜0.05). The vascular recanalization time of 50 reflow patients in the control group (10 cases without reflow) was (8.32±1.25) h, whereas the vascular recanalization time of 57 reflow patients in the observation group (3 cases without reflow) was (8.10±1.21) h, with no statistically significant differences between the two groups (P＞0.05). At 6 months after surgery, the incidence of adverse cardiovascular events in the observation group (6.7%) was significantly lower than that in the control group (20.0%), and the difference was statistically significant (P＜0.05). ConclusionEmploying ticagrelor in treating patients with acute ST-segment elevation myocardial infarction undergoing PCI can effectively improve the postoperative coronary blood flow, reduce the occurrence of no-reflow, and decrease the incidence of adverse cardiovascular events, which is worthy of promotion and application.