BACKGROUND:To analyze the cardio-protective effects of ticagrelor in patients with acute coronary syndrome with S-T segment elevation.METHODS:The sample was 200 patients who had been diagnosed with acute coronary syndrome accompanied by diabetes Mellitus type II. Only patients having ST segment elevation before the treatment were included. Then, the subjects were further randomly divided into an observation group and a control group. The control group of 100 patients received clopidogrel; the observation group of 100 patients of ticagrelor. The serous creatine kinase CK-MB, functional cardiac indexes of left ventricular end diastolic diameter (LVDD), cardiac troponin I, ventricular ejection fraction, and relevant major adverse cardiovascular events (MACE) were compared between the two groups.RESULTS:One month after a percutaneous coronary intervention (PCI) the observation group showed better results against angina, stent thrombosis, and all-cause mortality compared with those of the control subjects. Six months after treatment, both groups suffered adverse reactions. The number of patients who suffered adverse reactions in respiratory tract in the observation group was higher than in the control group. The inhibition of platelet aggregation IPA of ticagrelor was found to be significantly higher than clopidogrel, having a significant p value.CONCLUSION:Ticagrelor can effectively protect myocardial function for patients with ST-segment elevation acute coronary syndrome accompanied by diabetes and can reduce the incidence of adverse reactions..

目的探讨体外膜肺氧合（ECMO）联合主动脉内球囊反搏（IABP）预防性应用于高危经皮冠状动脉介入治疗（HR-PCI）患者的短期临床疗效。方法选择2018年5–8月10例HRPCI患者,术中应用ECMO联合IABP循环支持。结果 10例患者中男性8例,女性2例,年龄51～84（70.3±11.1）岁,平均左心室射血分数（35.7±10.2）%。10例患者均为严重三支病变,左主干病变7例,其中合并右冠状动脉（RCA）慢性完全闭塞（CTO）病变5例,前降支CTO病变2例;剩余3例中2例为RCA和左前降支（LAD）近/中段CTO病变,1例为RCA CTO病变合并LAD/左回旋支（LCX）严重狭窄。在ECMO联合IABP支持下7例左主干病变中先处理左主干病变6例,1例处理了RAC CTO病变和LAD重度狭窄;剩余3例中2例RCA和LAD近/中段CTO病变均先处理了LAD CTO病变,另1例RCA CTO病变合并LAD/LCX严重病变患者先处理了RCA CTO病变。术中ECMO平均灌注流量（1.80±0.30）L/min,总运转时间（3.4±0.7）h。PCI平均手术时间（2.2±0.5）h。1例PCI术中发生血流动力学崩溃,ECMO灌注流量提高到3.0 L/min维持血流动力学,直到循环正常。术后所有患者ECMO均成功撤机。2例患者IABP穿刺部位血肿,其中1例术后发现假性动脉瘤;1例术后于ICU发生室性心动过速和心室颤动;无ECMO管道机械性问题、下肢缺血和感染并发症发生。结论对不适合行外科血管重建术的HR-PCI术患者,ECMO联合IABP循环支持下行PCI术是可行的。

To explore the function and importance of Extracorporeal membrane oxygenation (ECMO) combined with Intra-aortic balloon pump (IABP) support for high-risk percutaneous coronary intervention (PCI). We analyzed 7 cases undergoing high-risk PCI assisted by ECMO combined with IABP from May 2012 to