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目的:分析冠脉内替罗非班和山莨菪碱联合注射改善急性ST段抬高型心肌梗死(STEMI)患者冠脉介入手术(PCI)术后心肌血流灌注的效果。方法:78例在本院接受PCI术治疗STEMI患者随机分为对照组及观察组,对照组接受常规PCI术治疗,观察组在PCI术中进行冠脉替罗非班和山莨菪碱注射,对比两组的心肌血流灌注情况。结果:观察组PCI术后即刻及PCI术后4h的QRS波时限值均小于对照组(P<0.05);观察组PCI术后~(99m)Tc-MIBI、~(18)F-FDG摄取量大于对照组(P<0.05);观察组PCI术后4h血清单核细胞趋化因子-1(MCP-1)、细胞凋亡抑制因子(sFas)、羧基端糖基化肽(Copeptin)、骨桥蛋白(OPN)、血管血友病因子(vWF)水平均低于对照组(P<0.05)。结论:冠脉内替罗非班和山莨菪碱联合注射可以优化STEMI患者PCI术后心肌血流灌注,具有积极的临床意义。
Objective: To analyze the effect of intracoronary infusion of tirofiban and anisodamine on myocardial perfusion in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI). Methods: Seventy-eight patients with STEMI undergoing PCI in our hospital were randomly divided into control group and observation group. The control group received routine PCI. The observation group was injected with coronary Tirofiban and anisodamine during PCI. Myocardial perfusion in both groups. Results: The QRS wave limits of the observation group immediately after PCI and 4h after PCI were significantly lower than those of the control group (P <0.05). In the observation group, 99m Tc-MIBI and 18 F-FDG uptake (P <0.05). The levels of MCP-1, sFas, Copeptin, The levels of osteopontin (OPN) and von Willebrand factor (vWF) were lower than those of the control group (P <0.05). Conclusion: The combination of intracoronary injection of tirofiban and anisodamine can optimize myocardial perfusion in STEMI patients after PCI, which has a positive clinical significance.