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目的:评价替格瑞洛联合通心络胶囊在老年糖尿病合并急性心肌梗死(AMI)患者中的治疗作用。方法:选择2012年11月至2015年7月在我院心内科接受经皮冠状动脉介入(PCI)治疗的老年糖尿病合并AMI的患者258例,随机分为A、B、C、D共4组,A组为单纯PCI组(63例),B组为替格瑞洛组(66例),C组为通心络组(65例),D组为联合组(64例),分析各组的一般临床情况,术前、术后TIMI血流情况,术前及术后3个月各组左室射血分数(LVEF)和左室舒张末期内径(LVEDD),记录各组在随访6个月中主要不良心脑事件(MACCE)发生情况。结果:4组治疗前一般临床资料及TIMI血流、LVEF和LVEDD差异均无统计学意义(P>0.05)。D组术后TIMI血流情况及治疗3个月后LVEF和LVEDD优于其它组,6个月MACCE事件发生率明显低于A组和B组,C组的MACCE事件发生率低于A组,差异具有统计学意义(P<0.05)。结论:对于老年糖尿病并发AMI的患者,在行PCI治疗的同时联合应用替格瑞洛和通心络胶囊治疗具有较好的临床疗效,可改善患者的预后,值得在临床上推广应用。
Objective: To evaluate the therapeutic effect of ticagrelor combined with tongxinluo capsule in senile diabetic patients with acute myocardial infarction (AMI). Methods: A total of 258 elderly patients with AMI complicated with percutaneous coronary intervention (PCI) who underwent percutaneous coronary intervention in our department from November 2012 to July 2015 were randomly divided into 4 groups: A, B, C and D , Group A was PCI alone (63 cases), Group B was ticagrelor (66 cases), Group C was Tongxinluo (65 cases), Group D was combination group (64 cases) The preoperative and postoperative TIMI blood flow, the left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVEDD) were recorded before and 3 months after operation in each group. Six patients were followed up The month of major adverse cardiovascular events (MACCE) occurred. Results: The clinical data and TIMI blood flow, LVEF and LVEDD were not significantly different between the 4 groups before treatment (P> 0.05). TIMI blood flow in group D and LVEF and LVEDD after 3 months of treatment were superior to those in other groups. The incidence of MACCE was significantly lower in 6 months than in groups A and B. The incidence of MACCE in group C was lower than that in group A, The difference was statistically significant (P <0.05). Conclusion: For patients with senile diabetes mellitus complicated with AMI, the combination of ticagrelor and Tongxinluo capsule in the treatment of PCI has better clinical curative effect, which can improve the prognosis of patients and is worth popularizing in clinic.