摘要
目的探讨血栓抽吸联合疗法对于急性ST段抬高型心肌梗死(STEMI)患者急诊PCI术再灌注损伤的影响。方法选取我院接受急诊PCI术STEMI患者132例作为研究对象,将其随机分为观察组(70例)与对照组(62例)。观察组在抽吸治疗后冠状动脉内给予替罗非班及硝普钠后行PCI,对照组抽吸后直接行PCI。比较两组临床基线资料,术后TIMI及CTFC。检测术后CK-MB峰值水平,术后1周NTProBNP,LVEF,LVDd,术后1个月MACE以及处理前后血压、心率。结果 PCI术前,两组基线临床特征资料对比,差异无统计学意义(P> 0.05)。两组患者的无复流或慢血流的发生率比较,差异具有统计学意义(P <0.01);观察组患者TIMI3级的达标率高于对照组,差异具有统计学意义(P <0.01);观察组患者CTFC帧数降低幅度高于对照组,差异具有统计学意义(P <0.05);观察组患者NT-ProBNP浓度低于对照组,差异具有统计学意义(P <0.05);观察组患者CK-MB峰值低于对照组,差异具有统计学意义(P <0.05);LVEF高于对照组,差异具有统计学意义(P <0.05)。而两组患者LVDd指标与MACE事件发生例数比较,差异无统计学意义(P> 0.05)。两组处理前后收缩压、舒张压及心率情况比较,差异无统计学意义(P> 0.05)。结论急诊PCI术中应用血栓抽吸联合疗法可显著改善TIMI血流,减轻再灌注损伤,改善心功能。
Objective To study the effect of thrombosis aspiration combined therapy on reperfusion injury of patients with acute myocardial infarction （STEMI）. Methods A total of 132 cases of ST-segment elevation myocardial infarction （STEMI） patients with emergency percutaneous coronary injection （PCI） were selected as the study objects and they were randomly divided into control group （thrombus aspiration only, 62 cases） and observation group （thrombus aspiration and intracoronary tirofiban combined with sodium nitroprusside injection, 70 cases）. Baseline clinical data, thrombolysis in myocardial infarction （TIMI） and corrected TIMI framecount （CTFC）, TIMI blood fow, CK-MB paek value, brain natriuretic peptide precursor （NT-ProBNP） concentration and left ventricular ejection fraction （LVEF）, left ventricular end-diastolic diameter （LVDd） were compared in two groups. The major adverse cardiac event （MACE） was compared in one month after PCI. The blood pressure and heart rate between two groups were compared to evaluate the safety. Results There was no significant difference in baseline clinical characteristics between the two groups before PCI （P 〉 0.05）. There was a signifcant difference in the incidence of no-refow or slow blood fow between the two groups （P〈 0.01）. The compliance rate of TIMI3 level in the observation group was higher than that in the control group, and the difference was statistically significant （P 〈 0.01）. The decrease of CTFC frames in the observation group was significantly higher than that in the control group （P 〈 0.05）. The concentration of NT-ProBNP in the observation group was lower than that in the control group, and the difference was statistically signifcant （P 〈 0.05）. The peak value of CK-MB in the observation group was lower than that in the control group （P 〈 0.05）. LVEF was higher than that of the control group, and the difference was statistically signifcant （P 〈 0.05）. There was no signifcant diffe
作者
翁志远
张奇
佟辉
WENG Zhiyuan;ZHANG Qi;TONG Hui(The First Department of Cardiology,Jiamusi Central Hospital,Jiamusi Heilongjiang 154002,China)
出处
《中国继续医学教育》
2018年第33期134-137,共4页
China Continuing Medical Education
