Short Term Efficacy of Ticagrelor Combined with Thrombolytic Therapy for Patients with ST-segment Elevation Myocardial Infarction(STEMI) Complicated with Type 2 Diabetes and Its Effects on Level of Inflammatory Factors
YOU San-li,WANG Zhao
The Second People's Hospital of Hunan Province, Brain Hospital Affiliated to Hunan University of Traditional Chinese Medicine, Changsha, 410078
Abstract：【Objective】To explore the short term efficacy of ticagrelor combined with thrombolytic therapy for patients with ST-segment elevation myocardial infarction (STEMI) complicated with type 2 diabetes and its effects on level of inflammatory factors.【Methods】A total of 70 acute STEMI patients with type 2 diabetes, who underwent thrombolytic therapy in our hospital from February 2015 to February 2017, were randomly divided into the ticagrelor group (n=35) and the clopidogrel group (n=35) according to the random number table method. Both groups were given aspirin anti-platelet aggregation and other conventional treatment. In addition, the ticagrelor group was given ticagrelor and urokinase, while the clopidogrel group was given clopidogrel and urokinase The total clinical effective rate and the percentage of ST segment regression >50% after 1h and 2h thrombolysis were compared between the two groups. The levels of High sensitive C reactive protein (hs-CRP) and interleukin-6 (IL-6) before and 1d, 3d, 7d after treatment were detected. The incidence of recurrent myocardial infarction within 1 week, as well as the left ventricular end diastolic diameter (LVEDD)and left ventricular ejection fraction (LVEF)after 1 week were recorded.【Results】There were no significant differences in serum hs-CRP and IL-6 levels between the two groups before treatment (P> 0.05). The levels of hs-CRP and IL-6 in both groups were significantly lower at 1, 3 and 7 days after treatment compared to before treatment. Hs-CRP and IL-6 level changes in the ticagrelor group were significantly lower than those in the clopidogrel group; the difference was statistically significant (P <0.05). The total effective rates of the ticagrelor group were 80.0% (28/35) and 94.3% (33/35) after thrombolysis for 1and 2 h, respectively, which were significantly higher than those of the clopidogrel group 71.5% (25/35)and 88.6% (31/35), respectively; the differences were statistically significant (P<0.05).The percentage of ST segment regression >50% after 1h and 2h thrombolysis in the ticagrelor group were 74.3% and 97.1%, respectively, which were significant higher than those in the clopidogrel group 62.9%and 91.4%, respectively;those of the ticagrelor group were higher than the clopidogrel group (P<0.05). After 1 week of treatment, the LVEDD in the ticagrelor group was significantly lower than that in clopidogrel group (45.2 ± 3.4) mm vs (50.3 ± 3.9) mm, and the LVEF in the ticagrelor group was significantly higher than that in the clopidogrel group (62.8±4.2)% vs (55.2 ± 3.8)%; the difference was statistically significant (P <0.05). The incidence of reccurrent infarction within 1 week in the ticagrelor group was 0.0%, while the incidence in the clopidogrel group was 5.7% (2/35); the difference was statistically significant (P<0.05).【Conclusion】The short term efficacy of ticagrelor combined with thrombolytic therapy for patients with STEMI complicated with type 2 diabetes is good. The treatment significantly improves the success rate of thrombolysis and cardiac function, reduces inflammatory factors after myocardial infarction and the rate of recurrent myocardial infarctions.
游三丽,王照. 替格瑞洛联合溶栓治疗合并2型糖尿病的急性STEMI患者近期疗效及其对炎性因子水平的影响[J]. 医学临床研究, 2018, 35(1): 22-25.
YOU San-li,WANG Zhao. Short Term Efficacy of Ticagrelor Combined with Thrombolytic Therapy for Patients with ST-segment Elevation Myocardial Infarction(STEMI) Complicated with Type 2 Diabetes and Its Effects on Level of Inflammatory Factors. JOURNAL OF CLINICAL RESEARCH, 2018, 35(1): 22-25.
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2018, Vol. 35 
