论文部分内容阅读
目的探析替罗非班联合前列地尔对经急性经皮冠脉介入治疗(PCI)术治疗的ST段抬高型心肌梗死(STEMI)患者的心功能短期预后与心肌再灌注的影响。方法分析2014年2月至2016年2月接受急诊PCI术治疗的81例STEMI患者,随机将入选者分为A组(替罗非班组)、B组(替罗非班+前列地尔联合组)与C组(常规组),每组27例。比较3组患者治疗后心肌坏死相关指标及心肌再灌注损伤相关指标的峰值、治疗24 h和14 d后患者的血浆N-末端脑钠肽前体(NT-pro BNP)浓度及左心室射血分数(LVEF)值。结果 A、B组患者术后血清乳酸脱氢酶(LDH)、肌酸激酶同工酶(CK-MB)及肌酸激酶(CK)峰值水平显著低于C组(P均<0.05)。A、C组的血清超敏C反应蛋白(hs-CRP)、内皮素(ET)及肿瘤坏死因子-α(TNF-α)峰值水平均明显高于B组(P均<0.05)。术后A、B组患者的血小板计数明显较同组术前低(P<0.05)。3组患者治疗24 h后血浆NT-pro BNP浓度及LVEF值无差异(P均>0.05);治疗14 d后,A、C组患者的血浆NT-pro BNP浓度明显高于B组,且LVEF值明显低于B组(P均<0.05)。治疗后3组患者均未出现明显不良反应。结论替罗非班、前列地尔在急性PCI术后的联合应用可显著改善患者的心肌微循环,有效缓解心肌再灌注损伤,对心功能短期预后与心肌再灌注方面的作用优于单用替罗非班。
Objective To investigate the effect of tirofiban and alprostadil on short-term cardiac function and myocardial reperfusion in patients with ST-elevation acute myocardial infarction (STEMI) undergoing acute percutaneous coronary intervention (PCI). Methods Totally 81 STEMI patients undergoing emergency PCI between February 2014 and February 2016 were enrolled. Patients were randomly divided into A group (tirofiban group), B group (tirofiban + alprostadil group) ) And C group (conventional group), 27 cases in each group. The peak value of myocardial ischemia-related index and myocardial reperfusion injury-related index were compared between the three groups. After treatment for 24 and 14 days, the plasma N-terminal proBNP (NT-pro BNP) and left ventricular ejection fraction Score (LVEF) value. Results The peak levels of serum LDH, CK-MB and CK in group A and group B were significantly lower than those in group C (all P <0.05). The peak levels of serum hs-CRP, ET and TNF-α in group A and group C were significantly higher than those in group B (all P <0.05). Postoperative patients in group A and group B had significantly lower platelet counts (P <0.05) than those in the same group. The plasma NT-pro BNP concentration and LVEF were no difference between the three groups (all P> 0.05) after 24 h of treatment; the plasma NT-pro BNP concentrations of patients in groups A and C were significantly higher than those in group B after 14 days of treatment, and LVEF Value was significantly lower than the B group (P all <0.05). Three groups of patients after treatment showed no obvious adverse reactions. Conclusion The combination of Tirofiban and Alprostadil after acute PCI can significantly improve myocardial microcirculation and relieve myocardial reperfusion injury effectively, which has a better effect on myocardial short-term prognosis and myocardial reperfusion than single use Luo Fei ban.