摘要
目的:研究冠脉内注射替罗非班在高龄ST段抬高型心肌梗死(STEMI)患者经皮冠脉介入治疗(PCI)治疗中的应用效果。方法:选择于我院行PCI的高龄STEMI患者116例,依据随机数字表法分为常规治疗组(58例,PCI常规治疗)与替罗非班组(58例,替罗非班联合PCI常规治疗)。观察两组PCI后12h、24h、72h、7d血清N末端B型利钠肽原(NT-proBNP)水平,PCI后7dTIMI血流分级、出血率,PCI前及PCI后1年左室舒张末期容积指数(LVEDVI)、左室收缩末期容积指数(LVESVI)与左室射血分数(LVEF)值,PCI后1年心脏不良事件发生率等指标。结果:替罗非班组PCI后12h、24h、72h、7d血清NT-proBNP水平均明显低于常规治疗组(P均=0.001)。PCI后7d,替罗非班组TIMI 3级比例明显高于常规治疗组(93.11%比62.07%,P=0.001)。PCI后1年,与常规治疗组比较,替罗非班组LVEF[(41.95±4.18)%比(47.18±4.83)%]明显提高,LVESVI[(43.03±4.21)ml/m^2比(39.42±3.87)ml/m^2]、LVEDVI[(62.05±6.17)ml/m^2比(58.46±5.91)ml/m^2]明显减小,心脏不良事件发生率明显降低(37.93%比18.97%),P<0.05或<0.01。两组出血率无显著差异(P>0.05)。结论:在高龄STEMI患者,PCI术中冠脉内注射替罗非班可显著改善心肌血流及心功能,且心脏不良事件发生率低,值得应用于临床。
Objective：To study effects of intracoronary tirofiban injection during percutaneous coronary intervention（PCI）in advanced aged patients with ST elevation myocardial infarction（STEMI）.Methods：A total of 116 advanced aged STEMI patients undergoing PCI in our hospital were selected.According to random number table,they were randomly and equally divided into routine treatment group（received routine PCI）and tirofiban group（received routine PCI combined tirofiban）.Serum N terminal pro brain natriuretic peptide（NT-proBNP）level on 12 h,24 h,72 hand 7 dafter PCI,TIMI blood flow grade and incidence rate of hemorrhage on 7 dafter PCI,left ventricular end-diastolic volume index（LVEDVI）,left ventricular end-systolic volume index（LVESVI）and left ventricular ejection fraction（LVEF）before and one year after PCI,incidence rate of adverse cardiac events on one year after PCI were observed and compared between two groups.Results：Serum NT-proBNP level of tirofiban group on 12 h,24 h,72 hand 7 dafter PCI was significantly lower than that of routine treatment group,P=0.001 all.On 7 dafter PCI,percentage of TIMI grade 3 in tirofiban group was significantly higher than that of routine treatment group（93.11% vs.62.07%,P=0.001）.Compared with routine treatment group on one year after PCI,there was significant rise in LVEF [（41.95±4.18）% vs.（47.18±4.83）%],and significant reductions in LVESVI[（43.03±4.21）ml/m2 vs.（39.42±3.87）ml/m2],LVEDVI [（62.05±6.17）ml/m2 vs.（58.46±5.91）ml/m2]and incidence rate of adverse cardiac events（37.93% vs.18.97%）in tirofiban group,P〈0.05 or〈0.01.There were no significant difference in incidence rate of hemorrhage between two groups,P〉0.05.Conclusion：Intracoronary tirofiban injection during PCI in advanced aged STEMI patients can significantly improve myocardial blood flow,cardiac function and reducing incidence rates of adverse cardiac events,which is worth extending in clinic.
作者
李红梅
LI Hong-mei(Department of Cardiology, People＇s Hospital of Jianli County, Jingzhou, Hubei, 433300, China)
出处
《心血管康复医学杂志》
CAS
2018年第3期326-331,共6页
Chinese Journal of Cardiovascular Rehabilitation Medicine
