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目的分析替罗非班联合美托洛尔对急性心肌梗死(acute myocardial infarction,AMI)患者血流动力学及血清基质金属蛋白酶9(serum matrix metalloproteinases-9,MMP-9)、C反应蛋白(C-reaction protein,CRP)水平的影响。方法选取2015年1月—2016年12月收治的92例AMI患者作为研究对象,随机分为对照组和研究组各46例。对照组予以美托洛尔,研究组予以替罗非班+美托洛尔。统计对比两组治疗效果、血流动力学指标[平均二尖瓣压力差(mean mitral valve pressure,m MVP)、左房平均压(mean left atrium pressure,m LAP)、肺动脉平均压(mean pulmonary artery pressure,m PAP)]变化情况、血清MMP-9、CRP水平变化情况。计量资料组间比较采用t检验,组内比较采用配对t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果研究组治疗总有效率为97.83%(45/46),高于对照组的73.91%(34/46),差异有统计学意义(P<0.05)。治疗后,研究组m PAP、m LAP、m MVP水平分别为(4.36±0.51)、(1.82±0.47)、(0.97±0.40)k Pa,均低于对照组的(5.56±0.62)、(2.76±0.58)、(1.64±0.44)k Pa,差异均有统计学意义(均P<0.05)。治疗后,研究组MMP-9、CRP水平分别为(343.81±42.14)μg/L、(5.22±1.57)mg/L,低于对照组的(375.24±44.53)μg/L、(6.59±1.88)mg/L,差异均有统计学意义(均P<0.05)。结论替罗非班联合美托洛尔可稳定AMI患者血流动力学,降低MMP-9、CRP水平,提高治疗效果。
Objective To analyze the effects of tirofiban combined with metoprolol on hemodynamics and serum matrix metalloproteinases-9 (MMP-9) and C-reactive protein (C) in patients with acute myocardial infarction -reaction protein (CRP) levels. Methods A total of 92 patients with AMI who were admitted from January 2015 to December 2016 were randomly divided into control group and study group with 46 cases each. The control group was metoprolol, and the study group was given tirofiban + metoprolol. The effects of two groups on the treatment effect, hemodynamic parameters [mean mitral valve pressure (m MVP), mean left atrium pressure (m LAP), mean pulmonary artery pressure, m PAP)] changes, serum MMP-9, CRP level changes. Measurement data were compared between groups using t test, the group was compared using paired t test, count data using χ2 test, P <0.05 for the difference was statistically significant. Results The total effective rate of the study group was 97.83% (45/46), which was significantly higher than that of the control group (73.91%, 34/46). The difference was statistically significant (P <0.05). After treatment, the levels of mPa, m LAP and m MVP in the study group were (4.36 ± 0.51), (1.82 ± 0.47) and (0.97 ± 0.40) kPa, respectively, which were lower than those in the control group (5.56 ± 0.62 and 2.76 ± 0.58) and (1.64 ± 0.44) k Pa, respectively (all P <0.05). After treatment, the levels of MMP-9 and CRP in the study group were (343.81 ± 42.14) μg / L and (5.22 ± 1.57) mg / L, respectively, lower than those in the control group (375.24 ± 44.53 μg / L, 6.59 ± 1.88) mg / L, the differences were statistically significant (all P <0.05). Conclusion Tirofiban combined with metoprolol can stabilize the hemodynamics of patients with AMI, reduce the levels of MMP-9 and CRP, and improve the therapeutic effect.