摘要
目的探讨替罗非班联合美托洛尔治疗急性心肌梗死的疗效及其作用机制。方法 90例急性心肌梗死患者随机分为试验组45例和对照组45例。对照组给予美托洛尔口服治疗,试验组给予替罗非班静脉和美托洛尔口服治疗,治疗7d后观察两组患者的临床疗效,彩色多普勒超声心动图测定血流动力学,心脏彩超检测心功能,ELISA检测血清基质金属蛋白酶9,免疫透射比浊法检测血清C反应蛋白,流式细胞仪检测患者循环血管内皮祖细胞。结果试验组的总有效率95.56%显著高于对照组的80.00%,两组比较差异有统计学意义(P<0.05)。试验组的血流动力学参数左房平均压、平均二尖瓣压力差、肺动脉平均压改善程度优于对照组,心脏超声相关指标改善程度显著优于对照组,差异均有统计学意义(P<0.05)。治疗后两组患者血清基质金属蛋白酶9水平和C反应蛋白降低,且试验组低于对照组,差异均有统计学意义(P<0.01)。试验组患者的循环血管内皮祖细胞明显高于对照组,差异均有统计学意义(P<0.05)。结论替罗非班联合美托洛尔治疗急性心肌梗死的临床疗效良好,可有效改善血流动力学参数和心脏超声相关指标,可能与降低患者基质金属蛋白酶9和C反应蛋白的表达水平,提高循环血管内皮祖细胞的数量有关。
Objective To explore the efficacy and mechanism of tirofiban combined with metoprolol in patients with acute myocardial infarction. Methods Ninety patients with acute myocardial infarction were randomized into experimental group( n = 45) and control group( n = 45). The control group was treated by oral administration of metoprolol,and the experimental group by oral administration of metoprolol and intravenous admistration of tirofiban. After 7 days of treatment,the clinical curative effect,hemodynamic parameters,cardiac function indexes,the level of serum matrix metalloproteinases 9,C-reactive protein and endothelial progenitor cells were observed. Results The total effective rate in experimental group( 95. 56%) was higher than the control group( 80. 00%,P < 0. 05).The LAP MVP and m PAP of hemodynamic parameters and the echocardiogram related indexes in experimental group were better than those in control group( P < 0. 05). The serum levels of matrix metalloproteinases 9 and C-reactive protein in experimental group were lower than those in control group( P < 0. 01). The endothelial progenitor cells in experimental group were higher than those in control group( P < 0. 05). Conclusions Tirofiban combined with metoprolol in patients with acute myocardial infarction achieved good clinical curative effect,which can improve the hemodynamic parameters and related parameters of cardiac ultrasound. They may be related to the decrease in the expression of matrix metalloproteinases 9 and C-reactive protein and the increase of the endothelial progenitor cells.
出处
《安徽医药》
CAS
2016年第5期969-972,共4页
Anhui Medical and Pharmaceutical Journal
基金
国家自然科学基金资助项目(No 81273878)
