摘要
【目的】探讨早期经皮冠状动脉介入(PCI)术前负荷剂量替格瑞洛对急性心肌梗死(AMI)患者冠脉血流、心肌酶谱及同型半胱氨酸(Hcy)、成纤维细胞生长因子23(FGF23)、Klotho蛋白的影响。【方法】回顾性分析2017年1月至2019年3月本院收治的180例行PCI术治疗的AMI患者的临床资料,根据治疗方法的不同将其分为对照组(n=89)和观察组(n=91)。比较两组术后即刻心肌血流灌注情况,术后心肌酶五项到达峰值时间,及入院时、术后12周Hcy、FGF23、Klotho蛋白水平,心血管事件及不良事件发生情况。【结果】观察组术后校正的TIMI血流帧数(cTFC)及术后无复流或慢血流发生率显著低于对照组(P<0.05);观察组肌酸激酶同工酶(CK-MB)、磷酸肌酸激酶(CK)、乳酸脱氢酶(LDH)、谷草转氨酶(AST)、α-羟丁酸脱氢酶(α-HBD)达峰时间较对照组显著提前(P<0.05)。观察组患者血清Hcy、FGF23水平均低于对照组(P<0.05),Klotho蛋白水平高于对照组(P<0.05)。两组患者治疗期间不良事反应发生率比较,差异无统计学意义(P>0.05)。随访12周,观察组心血管事件发生率显著低于对照组(P<0.05)。【结论】PCI术前负荷剂量替格瑞洛能够有效改善AMI患者术后冠脉血流,更好地缓解心肌细胞损伤情况,降低心血管事件发生率。
【Objective】To investigate the effects of loading dose tegrilol before early percutaneous coronary intervention(PCI)on coronary blood flow,myocardial zymogram,homocysteine(Hcy),fibroblast growth factor 23(FGF23)and Klotho protein in patients with acute myocardial infarction(AMI).【Methods】The clinical data of 180 AMI patients treated with PCI in our hospital from January 2017 to March 2019 were retrospectively analyzed.They were divided into control group(n=89)and observation group(n=91)according to different treatment methods.The myocardial blood perfusion immediately after operation,the peak time of five postoperative myocardial enzymes,the levels of Hcy,FGF23,Klotho protein at admission and 12 weeks after operation,cardiovascular events and adverse events were compared between the two groups.【Results】The corrected TIMI blood flow frame number(cTFC)and the incidence of no reflow or slow blood flow after operation in the observation group were significantly lower than those in the control group(P<0.05);The peak time of Creatine kinase isoenzyme(CK-MB),creatine kinase phosphate(CK),lactate dehydrogenase(LDH),aspartate aminotransferase(AST),α-Hydroxybutyrate dehydrogenase(α-HBD)was significantly earlier than that of the control group(P<0.05).The levels of serum Hcy and FGF23 in the observation group were lower than those in the control group(P<0.05),and the level of Klotho protein was higher than that in the control group(P<0.05).There was no significant difference in the incidence of adverse events between the two groups during treatment(P>0.05).After 12 weeks of follow-up,the incidence of cardiovascular events in the observation group was significantly lower than that in the control group(P<0.05).【Conclusion】The loading dose of tegranolol before PCI can effectively improve the coronary blood flow in patients with AMI,better alleviate the injury of myocardial cells,and reduce the incidence of cardiovascular events.
作者
蔡海军
张培
CAI Hai-jun;ZHANG Pei(Ankang Hospital of Traditional Chinese Medicine,Ankang Shaanxi 725000)
出处
《医学临床研究》
CAS
2022年第7期1047-1050,共4页
Journal of Clinical Research
