Objective:To investigate the clinical characteristics and structural and functional cardiac changes in heart failure with preserved ejection fraction(HFpEF)complicated with atrial fibrillation(AF)in elderly patients.Methods:As a cross-sectional study, 835 patients with HFpEF aged ≥60 years admitted to the Department of Geriatric Cardiovascular Medicine of the First Hospital of Lanzhou University between April 2009 and December 2020 were divided into an HFpEF+ AF group(267 cases)and an HFpEF group(568 cases)according to whether they had AF in addition to HFpEF, and their cardiac structure and function were evaluated.The optimal cutoff point of the ratio of the peak early diastolic velocity(E)to the maximum early diastolic velocity(e')of the mitral annulus(E/e')was analysed using the receiver operating characteristic(ROC)curve.The HFpEF+ AF group was divided into two subgroups, E/e'>11 and E/e'≤11, and differences in their clinical presentation, cardiac structural and function, and the relationship between the left and right heart were compared.Results:Compared with the HFpEF group, the left atrial volume index(LAVi)was larger[(60.0±23.3)ml/m 2vs.(43.9±19.0)ml/m 2, t=10.130, P<0.01]and the left ventricular ejection fraction(EF), mitral annular septal systolic velocity(s' S)and E/e' were smaller than in the HFpEF+ AF group(all P<0.01), whereas the right ventricular diameter(RVD), right atrial diameter(RAD)and area(RAA), tricuspid regurgitation velocity(TRv), and pulmonary arterial systolic pressure(PASP)in the HFpEF+ AF group were all greater than those in the HFpEF group(all P<0.05).In the E/e'>11 subgroup of HFpEF+ AF, the prevalence of hypertension, coronary heart disease and diabetes were higher, AF courses were shorter, and the decline of s' was more severe(all P<0.05).Furthermore, E/e' was independently correlated with LAVi, as was LAVi with PASP( t=2.114, 1.963, P=0.034, 0.042).The above-mentioned features were similar to those in the HFpEF group.The E/e'≤11 subgroup had a higher proportion of women, longer duration of AF than the E/e'>11 subgroup(median: 5 years vs.1 year, P=0.003), more noticeable enlargement of the right ventricle and right atrium, higher TRv and PASP( P<0.05). Conclusions:In elderly patients with HFpEF complicated with AF, the left atrial volume is increased further, and left ventricular systolic function and right heart morphology show serious deterioration, suggesting there might be two phenotypes of HFpEF+ AF with different pathophysiological mechanisms.

Objective:To investigate the clinical efficacy of hemoperfusion in the treatment of severe organophosphorus poisoning and its effect on diaphragm function.Methods:Eighty-five patients with severe organophosphorus poisoning who received treatment in Affiliated Huxi Hospital of Jining Medical University (Shanxian Central Hospital), China between January 2018 and January 2020 were included in this study. They were randomly divided into treatment ( n = 43)and control ( n = 42) groups. The control group was given conventional treatment including gastric lavage, catharsis, and application of reactivators and anticholinergic drugs. The treatment group was subjected to three times of hemoperfusion, with an interval of 24 hours between two hemoperfusion interventions based on the conventional treatment used in the control group. Before and after three times of hemoperfusion, serum levels of cholinesterase (CHE), interleukin-6 (IL-6), arterial partial pressure of oxygen (PaO 2), and arterial partial pressure of carbon dioxide (PaCO 2) were measured. The Acute Physiology and Chronic Health Evaluation (APACHE) II score and oxygenation index (OI) in each group were calculated. Right diaphragmatic activity, diaphragmatic thickness at the end of inspiration (DTei) and diaphragmatic thickness at the end of expiration were measured by bedside ultrasound. The diaphragmatic thickening rate (DTF) and diaphragmatic rapid shallow breathing index (D-RSBI) were calculated. Serum CHE and IL-6 levels, OI, diaphragmatic activity, DTF and D-RSBI were compared between the treatment and control groups. The incidence of intermediate syndrome, tracheal intubation rate, 28-day mortality rate, and hospital stay were compared between the two groups. Results:Before hemoperfusion, there were no significant differences in serum levels of CHE and IL-6, OI, right diaphragmatic activity, DTF, and D-RSBI between the treatment and control groups (all P > 0.05). After three times of hemoperfusion, serum IL-6 level and D-RSBI in the treatment group were (37.9 ± 6.2) ng/L and (0.77 ± 0.20) times /min/mm, which were significantly lower than those in the control group [(45.9 ± 5.3) ng/L, (0.90 ± 0.16) times/min/mm ( t = -6.295, -3.382, P < 0.001, P = 0.001)]. Serum CHE level, OI, DE and DTF in the treatment group were (2.29 ± 0.52) kU/L, (264.5 ± 24.3) mmHg, (16.5 ± 1.9) mm, (27.2 ± 4.7) %, respectively, which were significantly higher than those in the control group [(1.96 ± 0.39) kU/L, (252.6 ± 27.2) mmHg, (14.3 ± 1.6) mm, (23.5 ± 4.1) %, t = 3.258, 2.141, 5.598, 3.877, all P < 0.05]. The incidence of intermediate syndrome, tracheal intubation rate, hospital stay in the treatment group were [4.7% (2/43)], [2.3% (1/43)] and [(11.8 ± 1.8) days], respectively, which were significantly lower than those in the control group [23.8% (10/42), 19.0% (8/42) and (12.9 ± 1.8) days, χ2 = 6.432, P = 0.011; χ2 = 6.276, P = 0.012; t = -2.932, P = 0.004]. There was no significant difference in 28-day mortality rate between the two groups ( P > 0.05). Conclusion:Hemoperfusion can improve diaphragmatic function, reduce inflammatory reaction and shorten hospital stay in patients with severe organophosphorus poisoning.

Objective:To explore the value of quantitative susceptibility mapping (QSM) in evaluating renal injury in patients with early diabetic nephropathy (DN).Methods:From October 2019 to December 2020, 32 patients with early DN were prospectively enrolled in the Third Affiliated Hospital of Soochow University. According to the estimated glomerular filtration rate (eGFR), they were divided into three groups: DN1 (eGFR≥90 ml·min -1·1.73 m -2, 11 cases), DN2 (60-<90 ml·min -1·1.73 m -2, 11 cases) and DN3 (30-<60 ml·min -1·1.73 m -2, 10 cases). At the same time, 32 normal volunteers were recruited as the control group. Both kidneys were scanned by QSM to measure the susceptibility of renal cortex and medulla. Paired samples t-test was used to compare the differences of the susceptibility between left and right kidneys and between cortex and medulla. One-way analysis of variance was performed to compare the differences of corresponding susceptibility values among different groups, and LSD- t was used for the pairwise comparison. Pearson correlation test was performed between the susceptibility value of the medulla and eGFR. The ROC curve was used to analyze the diagnostic efficacy of QSM parameters in the diagnosis of DN and different degrees of severity of DN. Results:The susceptibility values of bilateral renal medulla in normal volunteers and patients with DN were lower than those of renal cortex (all P<0.001). There was no significant difference in the susceptibility value between left and right renal cortex (all P>0.05). There was significant difference in the susceptibility value between left and right medulla (all P<0.05). There was no significant difference in the susceptibility value of bilateral renal cortex among the control group and the DN1－DN3 groups (both P>0.05). The susceptibility values of left renal medulla in control group, DN1, DN2 and DN3 groups were (-4.46±1.16)×10 -2, (-5.96±0.97)×10 -2, (-7.97±1.25)×10 -2, (-9.58±1.45)×10 -2 ppm, of right renal medulla were (-3.70±0.65)×10 -2, (-5.06±1.28)×10 -2, (-7.33±1.46)×10 -2, (-9.09±2.22)×10 -2 ppm, respectively. The overall difference of the susceptibility value of bilateral renal medulla was statistically significant (both P<0.05), and there were significant differences between each two groups (all P<0.05). The linear positive correlation were found between the susceptibility values of renal medulla and the corresponding eGFR (left kidney r=0.732, P<0.001; right kidney r=0.684, P<0.001). The areas under the ROC curve (AUC) of left and right renal medulla susceptibility value in diagnosis of normal and DN were 0.931 and 0.943, of DN1 and DN (2 and 3) were 0.952 and 0.883, of DN (1 and 2) and DN3 were 0.888 and 0.831, respectively. Conclusion:The susceptibility value of QSM quantitative parameter has a certain value in the staging and differential diagnosis of early DN, among which the susceptibility value of renal medulla has higher diagnostic efficiency.

Objective: To investigate the effect of early mobilization on gastrointestinal function and delirium in patients with mechanical ventilation of chronic obstructive pulmonary disease(COPD). Methods: A total of 87 mechanically ventilated patients with COPD who met the inclusion criteria were selected as subjects from April 2017 to March 2018 in intensive care unit(ICU) of Huxi Hospital Affiliated to Jining Medical College.The patients were divided into treatment group (44 cases) and control group (43 cases) by the random number table method.On the basis of the same conventional treatment, the treatment group received early mobilization.The incidence of acute gastrointestinal injury(AGI), duration of AGI, incidence of delirium, duration of delirium, days of mechanical ventilation and 28-day mortality were compared between the two groups. Results: The incidence rate of AGI in the treatment group was lower than that in the control group[40.9%(18/44) vs. 62.7%(27/43)], and the duration in the treatment group was shortened[(3.95±1.62)d vs. (5.23±2.03)d], and the incidence rate of delirium in the treatment group was lower[54.5%(24/44) vs. 76.7%(33/43)], the duration of delirium in the treatment group was shortened[(2.36±0.9)d vs. (3.25±1.27)d], the mechanical ventilation time in the treatment group was decreased[(6.39±1.76)d vs. (7.56± 1.49)d], the differences were statistically significant(χ²=4.17, t=-2.280, χ²=4.744, t=-2.919, -3.358, all P<0.05). There was no statistically significant difference in the rate of 28-day mortality between the two groups[2.3%(1/43) vs. 9.3%(4/43), χ²=-1.984, P>0.05]. Conclusion Early mobilization can reduce the incidence and duration of AGI and delirium in COPD patients with mechanical ventilation, reduce the severity of AGI, and shorten the time of mechanical ventilation.

Objective To explore the clinical value of transnasal high volume oxygen therapy in the treatment of patients with acute heart failure.Methods From January 2016 to January 2018,61 cases with acute heart failure in Huxi Hospital Affiliated to Jining Medical College were selected.The patients were randomly divided into control group and treatment group according to the digital table,31 cases in the control group and 30 cases in the treatment group.The two groups were routinely given control of fluid volume,analgesia,strong heart,diuresis,vasodilator,anti-platelet aggregation,camp support and so on.The control group was given conventional oxygen therapy,and the treatment group was treated with high flow oxygen through nose.Before treatment and 12h,24h,48h,72h after treatment,the left ventricular ejection fraction (LVEF),oxygen index (PaO2/FiO2),serum lactic acid (Lac),B type sodium and titanium (BNP) in serum,and the application rate of non-invasive mechanical ventilation and invasive mechanical ventilation in 7d were observed in the two groups.Results Compared with the control group,the LVEF of the treatment group in each time point increased [(35.58 ± 3.64) ％ vs.(37.77 ± 3.76) ％,(37.87 ± 3.58) ％ vs.(40.07 ±3.36)％,(44.94 ±3.19)％ vs.(46.83 ±3.21)％,(47.55 ±3.45％)％ vs.(40.07 ±3.36％)％,t =-2.308,-2.466,-2.316,-2.487,all P ＜ 0.05].The PaO2/FiO2 of the treatment group increased significantly at each time point after treatment [(177.39 ± 10.62) mmHg vs.(184.17 ± 10.49) mmHg,(188.00 ± 11.72) mmHg vs.(198.57 ± 18.47) mmHg,(204.06 ± 17.69) mmHg vs.(221.40 ± 23.80) mmHg,(265.23 ± 34.51) mmHg vs.(290.37 ± 26.72) mmHg,t =-2.507,-2.678,-3.236,-3.174,all P ＜ 0.05].The BNP level of the treatment group decreased significantly at each time point after treatment [(2 462.90 ± 288.00) ng/mL vs.(2 264.53 ± 366.44) ng/mL,(1 646.61 ± 377.19) ng/mL vs.(1 474.07 ± 214.03) ng/mL,(991.94 ± 242.95) ng/mL vs.(811.90 ±258.67) ng/mL,(653.77 ± 147.671) ng/mL vs.(526.47 ± 127.87) ng/mL,t =2.355,2.187,2.803,3.594,all P ＜ 0.05].The Lac level of the treatment group decreased significantly at 12h and 24h after treatment [(5.05 ± 0.69) mmol/L vs.(4.55 ± 0.80) mmol/L,(3.68 ± 0.89) mmol/L vs.(3.13 ± 0.77) mmol/L,t =2.610,2.601,all P ＜ 0.05],but there were no statistically significant differences between the two groups at 48h and 72h after treatment [(1.62 ± 0.65) mmol/L vs.(1.53 ± 0.65) mmol/L,(1.36 ± 0.64) mmol/L vs.(1.26 ± 0.46) mmol/L,all P ＞ 0.05].In the control group and the treatment group,the incidence rates of non-invasive mechanical ventilation in 7d were 35.48％ (11/31),13.33％ (4/30),respetively,the difference was statistically significant (x2 =4.034,P ＜ 0.05).In the control group and the treatment group,the incidence rates of invasive mechanical ventilation in 7d were 12.90％ (4/31),3.33％ (1/30),respetively,the difference was statistically significant (x2 =4.957,P ＜ 0.05).Conclusion Nasal high flow oxygen therapy has better clinical effect on patients with acute heart failure.It is a more active treatment measure,and is worthy of clinical application.

Objective To investigate the effect of early activities on risk factors of acute gastrointestinal injury (AGI) in patients with chronic obstructive pulmonary disease (COPD) induced by mechanical ventilation.Methods A total of 118 mechanically ventilated non-diabetic patients with chronic obstructive pulmonary disease who were admitted to our hospital from August 2017 to April 2018 were enrolled in the study.The patients were divided into AGI group (71 cases) and non-AGI group (47 cases) according to the presence or absence of AGI.The examined data were collected in the patients prospectively such as preprocalcitonin (PCT),D-lactic acid,serum albumin (ALB),fasting plasma glucose (FPG),fasting insulin (FINS),and Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) scores were calculated.The homeostasis model insulin resistance index was used (HOMA-IR) to assess the subjects' insulin resistance.Logistics regression analysis screened for risk factors that affected patients' AGI.The AGI patients were divided into treatment group (36 cases) and control group (35 cases) according to the random number table method.On the basis of the same conventional treatment,the treatment group were received early mobilization.The differences of PCT,D-lactate,FPG,HOMA-IR,APACHE Ⅱ scores,and AGI grades before and after treatment for 3 days were observed for both groups of patients.Results The PCT,D-lactate,FPG,HOMA-IR,and APACHE Ⅱ scores were higher in the AGI group than in the non-AGI group [(2.72 ±0.54)ng/ml vs (1.81 ±0.62)ng/ml;(17.43 ±2.63)mg/ml vs (13.61 ± 1.6)mg/ml;(10.1 ±l.0)mmol/L vs (8.4 ±0.9) mmol/L;(2.4 ±0.5) vs (1.7 ±0.4);(23.8 ±2.9) point vs (21.7 ±4.3)point],and the ALB were lower than non-AGl group [(29.1 ±2.2)g/L vs (30.6 ±3.2)g/L],with statistically significant difference (P ＜ 0.05).Multivariate logistic regression analysis showed that PCT,D-lactic acid,FPG,HOMA-IR,and APACHE Ⅱ scores were risk factors for AGI in mechanically ventilated non-diabetic patients with COPD (regression coefficients were 4.337,1.226,5.106,4.469,0.584 respectively,P ＜0.05).There were no significant difference in PCT,D-lactate,FPG,HOMA-IR,APACHE Ⅱ scores between the treatment group and the control group before treatment (P ＞ 0.05).The PCT,D-lactic acid,FPG,HOMA-IR,and APACHE Ⅱ scores in the treatment group were significantly lower than those in the control group after early treatment [(2.00 ± 0.49) ng/ml vs (2.34 ± 0.34) ng/ml;(15.38 ± 1.71)mg/ml vs (17.38 ±2.88)mg/ml;(8.9 ±0.9)mmol/L vs (9.6 ±0.7)mmol/L;(1.9 ± 0.4) vs (2.2 ± 0.4);(21.0 ± 1.8) point vs (22.2 ± 2.7) point],and AGI severity was reduced (There were 8,18,6,3 and 1 cases of 0,Ⅰ,Ⅱ,Ⅲ,and Ⅳ in the treatment group,and4,12,9,7 and 3 in the control group respectively),with statistically significant differences (P ＜ O.05).Conclusions PCT,Dlactic acid,FPG,HOMA-IR,and APACHE Ⅱ scores were risk factors for AGI in mechanically ventilated non-diabetic patients with COPD.Early mobilization could reduce the level of these risk factors and the severity of AGI.

Objective To investigate the effects of early mobilization therapy on gastrointestinal function and respiratory mechanics in mechanical ventilation patients with chronic obstructive pulmonary disease (COPD). Methods A prospective randomized controlled study was used. Eighty-five patients with COPD who had stable hemodynamics and required invasive mechanical ventilation from January to December 2017 were enrolled. The patients were divided into treatment group with 43 cases and control group with 42 cases according to the random number table method. The patients in both groups received conventional basic treatment, but the treatment group received early mobilization therapy. The conditions of acute gastrointestinal injury (AGI), incidence of ventilator-associated pneumonia (VAP), duration of mechanical ventilation, 28-day mortality and respiratory mechanics indexes before and after treatment including airway resistance (Raw), lung dynamic compliance (Cd), lung static compliance (Cs), intrinsic positive end expiratory pressure (PEEPi) were compared between 2 groups. Results There were no statistical difference in Raw, Cd, Cs and PEEPi before treatment between 2 groups (P＞0.05). The PEEPi and Raw after treatment in treatment group were significantly lower than those in control group:(6.51 ± 1.46) cmH2O (1 cmH2O=0.098 kPa) vs. (7.30 ± 1.61) cmH2O and (19.23 ± 2.62) cmH2O/(L·s) vs. (20.54 ± 2.50) cmH2O/(L·s), the Cs and Cd were significantly higher than those in control group:(53.14 ± 5.07) ml/cmH2O vs. (49.16 ± 5.10) ml/cmH2O and (26.63 ± 3.28) ml/cmH2O vs. (24.54 ± 1.97) ml/cmH2O, and there were statistical differences (P＜0.05 or＜0.01). The incidences of AGI, duration of AGI, duration of mechanical ventilation and incidence of VAP in treatment group were significantly lower than those in control group: 44.2% (19/43) vs. 66.7% (28/42), (3.56 ± 1.22) d vs. (4.26 ± 1.62) d, (6.79 ± 1.92) d vs. (7.64 ± 1.89) d and 2.3% (1/43) vs. 14.3% (6/42), the severity of AGI was significantly lower than that in control group (patients of gradeⅠ,Ⅱ,ⅢandⅣin treatment group were 11, 6, 1 and 1 case respectively, and patients of grade Ⅰ, Ⅱ, Ⅲ and Ⅳ in control group were 7, 12, 8 and 1 case respectively), and there were statistical differences (P＜0.05). There was statistical difference in 28-day mortality between 2 groups (P＞0.05). Conclusions The incidence of AGI in mechanical ventilation patients with COPD is high. Early mobilization therapy can reduce the incidence and duration of AGI in mechanically ventilated patients with COPD, and reduce airway resistance, increase Cd and Cs, reduce PEEPi, improve respiratory function, shorten mechanical ventilation time, and reduce the incidence of VAP, which is worthy of clinical promotion.

Objective To investigate the effect of early mobilization on diaphragmatic function in patients with mechanical ventilation (MV). Methods Sixty chronic obstructive pulmonary disease with acute exacerbation (AECOPD) patients with respiratory failure (RF) and underwent MV admitted to intensive care unit (ICU) of Huxi Affiliated Hospital of Jining Medical College from January 2016 to January 2017 were enrolled. The patients were divided into treatment group (n = 30) and control group (n = 30) by randomly number table method. The two groups were given analgesia, sedation, MV, antibiotics, nutritional support and other treatments. An implementation plan was developed based on the clinical practice of pain, irritability and delirium in adult patients (PAD) with ICU, while the treatment group was given early mobilization (such as joint activity, stand to the bed, 3 times a day). The diaphragmatic thickness at the end of expiration (DTee), diaphragmatic thickness at the end of inspiration (DTei) and diaphragmatic thickening fraction (DTF) were measured by bedside ultrasonography before and 24 hours, 48 hours, 3 days and 5 days after treatment respectively. Results There were no significant differences in the parameters of the diaphragm before treatment between the two groups. In the control group, DTee was gradually decreased at 5 days after treatment and was significantly lower than that before treatment (cm: 0.26±0.06 vs. 0.28±0.08, t = 3.045, 1 = 0.005). While there was no significant change in DTee in the treatment group. There was no significant difference in DTee between the two groups at different time points after treatment. DTei and DTF were significantly increased in the two groups after treatment, and reached the peak value at 48 hours; with the prolonged of MV time, DTei and DTF in the control group at 3 days and 5 days were significantly lower than those at 48 hours [DTei (cm): 0.35±0.07, 0.34±0.07 vs. 0.36±0.08; DTF: (29.29±11.01)%, (28.62±11.97)% vs. (32.48±15.63)%, all 1 < 0.01]; there were no significant changes in the treatment group. DTF in the treatment group at 3 days and 5 days was significantly higher than that in the control groups [(38.53±11.39)% vs. (29.29±11.01)%, (37.27±11.26)% vs. (28.62±11.97)%, both 1 < 0.01]. Conclusion MV can lead to diaphragmatic dysfunction, while early mobilization can delay diaphragmatic atrophy and systolic dysfunction in MV patients.

Objective To investigate the effects of sequential blood purification on cardiac function in patients with acute organophosphorus pesticide poisoning (AOPP),and to analyze its application value.Methods Forty-five patients with severe AOPP and toxic myocarditis were researched and randomly divided into two groups.Sequential blood purification included hemoperfusion(HP) and continuous veno-venous hemofiltration (CVVH).In treatment group,23 patients were treated with HP + CVVH on the basis of the conventional therapy.Twenty-two patients of control group received the conventional therapy with HP.The differences of two groups on left ventricular ejection fraction (LVEF) and B-type natriuretic peptide (BNP) were compared before treatment and at 24,48 and 72 h after treatment.Results Before treatment,the levels of LVEF and BNP in treatment group were (47.7 ± 9.8)％ and (511.3 ± 285.3) ng/L,in control group were (47.3 ± 10.2)％ and (535.4 ± 303.9) ng/L,and there were no significant differences (P ＞ 0.05).The levels of LVEF at each time point after treatment in treatment group were significantly higher than those of control group:(52.7 ± 7.3) ％ vs.(47.8 ± 8.4)％,(55.2 ± 5.2)％ vs.(50.6 ± 7.1)％,(60.7 ± 6.3)％ vs.(53.3 ± 5.2)％,and the levels of BNP in treatment group were significantly lower than those of control group:(320.7 ± 181.8) ng/L vs.(496.7 ±268.9) ng/L,(252.7 ±113.8) ng/L vs.(384.3 ±167.5) ng/L,(122.4 ±66.7) ng/L vs.(294.8 ± 121.8) ng/L,there were significant differences between two groups (P＜ 0.05 or ＜ 0.01).In treatment group,the levels of LVEF at 24,48 and 72 h after treatment were significantly increased:(52.7 ± 7.3)％,(55.2 ± 5.2)％,(60.7 ± 6.3)％ vs.(47.7 ± 9.8)％,and the levels of BNP were significantly decreased:(320.7 ± 181.8),(252.7 ± 113.8),(122.4 ±66.7) ng/L vs.(511.3 ±285.3) ng/L,there were significant differences (P ＜ 0.01).In control group,the levels of LVEF and BNP at 24 h after treatment were (47.8 ± 8.4)％ and (496.7 ± 268.9) ng/L,before treatment were (47.3 ± 10.2)％ and (535.4 ± 303.9) ng/L,and there were no significant differences (P ＞ 0.05);the levels of LVEF at 48 and 72 h after treatment were significantly increased:(50.6 ± 7.1)％,(53.3 ± 5.2)％ vs.(47.3 ± 10.2)％,the levels of BNP were significantly decreased:(384.3 ± 167.5),(294.8 ± 121.8) ng/L vs.(535.4 ± 303.9) ng/L,and there were significantl differences (P ＜ 0.05 or ＜ 0.01).Conclusion Sequential blood purification treatment of AOPP can reduce myocardial injury and improve the cardiac function.

Objective:To evaluate the safety and efficacy of antiplatelet therapy of ticagrelor on patients suffering from acute ST segment elevation myocardial infarction undergoing primary percutaneous coronary in-tervention. Methods:In the study, 96 patients suffering from acute ST segment elevation myocardial infarction onset within 12 h undergoing primary percutaneous coronary intervention from May to October in 2013 were randomly divided into ticagrelor group (n=48) and clopidogrel group (n=48) by using the method of random number table. Ticagrelor and clopidogrel antiplatelet treatment were used before and after operation. Their baseline data, coronary artery disease characteristics, platelet count, adenosine diphosphate(ADP)-induced platelet inhibition rate by thrombelastograph after 5 days of treatment, the major adverse cardiovascular events of the follow up for 6 months and bleeding complications were observed and compared in the two groups. Re-sults:The differences between the two groups of patients with their baseline data, the features of coronary ar-tery lesions, platelet count before and after 5 days of treatment had no statistical significance (P>0. 05). ADP induced platelet inhibition rate [(80. 2 ± 10. 7)%] after 5 days of treatment in ticagrelor group was sig-nificantly higher than that in clopidogrel group [(75. 3 ± 12. 1)%, P<0. 05]. The two groups of patients were followed up for 6 months, 8 cases of major adverse cardiovascular events occurred in clopidogrel group, 2 ca-ses of major adverse cardiovascular events occurred in ticagrelor group, and there was significant difference between the two groups (P<0. 05). The two groups (7 cases of 48 patients in ticagrelor group vs. 3 cases of 48 patients in clopidogrel group ) had no statistically significant difference in bleeding complications ( P>0. 05). Conclusion: Antiplatelet therapy of ticagrelor on patients suffering from acute ST segment elevation myocardial infarction undergoing emergency PCI has good efficacy and safety.