摘要
目的探讨替罗非班术前应用对冠心病经皮冠状动脉介入治疗(PCI)术患者血管内皮功能及基质金属蛋白酶-9(MMP-9)的影响。方法选择2017年1月至2019年1月陕西省核工业二一五医院心血管内科接诊的100例拟行PCI术的冠心病患者,按随机数表法分为观察组和对照组,每组50例,对照组在PCI术前给予低分子肝素100 U/kg静脉推注,在冠状动脉造影时给予负荷剂量替罗非班10μg/kg的静脉推注,之后以0.15μg·kg^-1·min^-1的速度持续泵入48 h,观察组患者于入院明确诊断为冠心病后即刻给予替罗非班治疗,剂量和用药方式和对照组相同。比较两组患者术前、术后3 d时的血管内皮功能、血清MMP-9、不良心血管事件及出血并发症发生率。结果术后3 d,观察组患者的血清内皮素(ET-1)为(55.04±4.72)pg/mL,明显低于对照组的(67.81±5.60)pg/mL,一氧化氮(NO)为(51.37±4.50)μmol/L,明显高于对照组的(43.64±4.21)μmol/L,差异均有统计学意义(P<0.05);术后3 d,观察组患者的血清MMP-9为(279.84±22.41)mg/L,明显低于对照组的(310.35±27.59)mg/L,差异有统计学意义(P<0.05);观察组术后28 d内的亚急性支架内血栓、紧急冠状动脉血运重建、再发心肌梗死、心律失常、脑卒中总发生率为6.0%,明显低于对照组的20.0%,差异有统计学意义(P<0.05);观察组患者的皮肤黏膜、消化道、呼吸道出血及血尿总发生率为14.0%,与对照组的12.0%比较差异无统计学意义(P>0.05)。结论替罗非班术前应用可有效改善冠心病患者PCI术后血管内皮功能及MMP-9,降低不良心血管事件发生率,且不增加出血并发症,值得临床推广应用。
Objective To study the effect of tirofiban on vascular endothelial function and matrix metalloproteinase-9(MMP-9)in patients with coronary heart disease undergoing percutaneous coronary intervention(PCI).Methods A total of 90 patients of coronary heart disease scheduled for PCI,who received therapy in Department of Cardiovascular Medicine,Shaanxi Province Nuclear Industry 215 Hospital from January 2017 to January 2019 were selected and divided into the observation group and control group according to random number table method,with 50 cases in each group.The control group received intravenous injection of low molecular weight heparin 100 U/kg before PCI,and intravenous injection of tirofiban 10μg/kg-1·min-1 at load dose during coronary angiography,and pumped continuously for 48 hours at a speed of 0.15μg/kg/min,while the observation group received irofiban after the patients were diagnosed as coronary heart disease after admission,and the dosage and mode of administration were the same as those in the control group.The vascular endothelial function,serum MMP-9,adverse cardiovascular events,and bleeding complications eration,the serum endothelin(ET-1)in the observation group was(55.04±4.72)pg/mL,which was significantly lower than(67.81±5.60)pg/mL of the control group;nitric oxide(NO)was(51.37±4.50)μmol/L,which was significantly higher than(43.64±4.21)μmol/L of the control group(all P<0.05);the serum MMP-9 in the observation group was(279.84±22.41)mg/L,which was significantly lower than(310.35±27.59)mg/L of the control group(P<0.05).The total incidence of subacute stent thrombosis,emergency coronary revascularization,recurrent myocardial infarction,arrhythmia and stroke within 28 days after operation in the observation group was 6.0%,which were significantly lower than 20.0%of the control group(P<0.05);the total incidence of skin mucosa,digestive tract,respiratory tract hemorrhage and hematuria b in the observation group was 14.0%versus 12.0%in the control group(P>0.05).Conclusion Tirofiban can effective
作者
雷晓敏
曹蕊
LEI Xiao-min;CAO Rui(Department of Cardiovascular Medicine,Shaanxi Province Nuclear Industry 215 Hospital,Xianyang 712000,Shaanxi,CHINA)
出处
《海南医学》
CAS
2019年第22期2872-2875,共4页
Hainan Medical Journal
关键词
替罗非班
冠心病
经皮冠状动脉介入治疗
血管内皮功能
基质金属蛋白酶-9
Tirofiban
Coronary heart disease
Percutaneous coronary intervention(PCI)
Vascular endothelial function
Matrix metalloproteinase-9(MMP-9)
