摘要
目的:探讨替罗非班对接受经皮冠状动脉介入治疗(PCI)的急性心肌梗死(AMI)患者血浆生长分化因子-15(GDF-15)及血清血小板活化因子(PAF)水平的影响。方法:选择2015年1月至2016年12月110例行急诊PCI治疗的AMI患者。根据随机数字表法,患者被随机均分为常规治疗组(接受双联抗血小板等治疗)与替罗非班组(在常规治疗组基础上加用替罗非班)。比较两组患者PCI术后TIMI血流分级、心功能、治疗前后血浆GDF-15及血清PAF水平及不良事件的发生率。结果:与常规治疗组比较,替罗非班组术后7d血清PAF[(10.2±1.7)μg/L比(8.3±1.4)μg/L]、血浆GDF-15[(2.6±0.8)μg/L比(1.5±0.6)μg/L]水平显著降低(P均=0.001)。与常规治疗组比较,替罗非班组术后6个月左室射血分数[(52.8±6.6)%比(57.5±7.3)%]显著升高,而左室收缩末期内径[(45.4±7.1)mm比(40.2±6.9)mm]、左室舒张末期内径[(57.0±7.2)mm比(52.4±7.6)mm]以及不良事件发生率(14.5%比1.8%)显著降低,P<0.05或<0.01。结论:与常规治疗组比较,替罗非班更显著降低PCI术后AMI患者血浆GDF-15、血清PAF水平,改善心功能,且安全性较好,值得推广。
Objective: To explore influence of tirofiban on plasma level of growth differentiation factor-15 (GDF-15) and serum level of platelet activating factor (PAF) in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI). Methods: A total of 110 AMI patients undergoing emergency PCI from Jan 2015 to Dec 2016 were selected. According to random number table, they were randomly and equally divided in-to routine treatment group (received dual antiplatelet therapy etc. ) and tirofiban group (received tirofiban based on routine treatment group). TIMI blood flow grade and cardiac function after PCI, plasma GDF-15 and serum PAF levels before and after treatment, and incidence of adverse events were compared between two groups. Results: Compared with routine treatment group on 7d after PCI, there were significant reductions in serum PAF level [ (10.2±1.7)μg/Lvs. (8.3±1.4) μg/L] and plasmaGDF-151evel[(2.6±0.8) μg/Lvs. (1.5±0.6) μg/L] in tirofiban group, P = 0. 001 both. Compared with routine treatment group on six months after PCI, there was signifi- cant rise in left ventricular ejection fraction [ (52.8 ± 6.6) % vs. (57.5 ± 7.3) % ], and significant reductions in left ventricular end-systolic dimension [(45.4 ± 7.1) mm vs. (40.2 ± 6.9) mm], left ventricular end-diastolic dimension [ (57.0 ± 7.2) mm vs. (52.4 ± 7.6) mm] and incidence rate of adverse events (14.5% vs. 1.8%) in tirofiban group, P〈0.05 or 〈0.01. Conclusion: Compared with routine treatment , tirofiban can more significantly reduce plasma GDF-15 and serum PAF levels, improve cardiac function in AMI patients after PCI, and it's safe, which is worth extending.
出处
《心血管康复医学杂志》
CAS
2017年第6期651-655,共5页
Chinese Journal of Cardiovascular Rehabilitation Medicine