摘要
目的:观察急性心肌梗死患者行冠状动脉介入治疗术(PCI)前应用替罗非班对后期血液灌流及治疗效果的影响。方法:选取2015年3月-2016年4月本院急诊部收治的91例急性心肌梗死患者,采用随机数字表法分为观察组和对照组,其中对照组45例(行PCI术治疗)、观察组46例(替罗非班+PCI术治疗),比较PCI术后两组血小板聚集率,对患者进行为期3个月随访,通过电话、短信等方式统计随访期患者不良事件(再次梗死、心绞痛、死亡、心功能不全)发生情况。同时对PCI术前后患者TIMI血流情况进行比较,使用超声观察患者治疗前后左心室功能指标舒张末期内径(LVEDD)及收缩末期内径(LVESD)变化情况。结果:PCI术前两组LVESD、LVDD指标水平比较,差异均无统计学意义(P>0.05);术后观察组左心室功能改善效果优于对照组,使用不同诱导剂血小板聚集率均低于对照组,差异均有统计学意义(P<0.05)。随访3个月观察组不良事件发生率(心功能不全、死亡、心绞痛、再次梗死)低于对照组,观察组血管再通率为97.8%,高于对照组的82.2%,且观察组术后再灌注及TIMI血流分级均优于对照组,差异均有统计学意义(P<0.05)。结论:急性心肌梗死患者PCI术前使用替罗非班,能提高血管再通率,避免术后血小板聚集,促进左心室功能恢复。
Objective： To observe the effect of Tirofiban on blood perfusion and therapeutic effect in patients with acute myocardial infarction undergoing pereutaneous coronary intervention （ PCI ） .Method： From March 2015 to April 2016, 91 acute myocardial infarction patients treated in our hospital were selected, and divided info observation group and control group according to the random number tablemethod, 45 cases in control group （ PCI treatment ）, 46 cases in observation group （ Tirofiban＋PCI treatment ）, platelet aggregation rate was compared between two groups, after PCI, the patients were followed up for 3 months by telephone and SMS, the adverse events （ reinfarction, anginapectoris, death and cardiac dysfunction ） were measured.At the same time, the blood flow conditionof patients with PCI before and after TIMI of two groups were compared, the changes of left ventricular function index included end diastolic diamete （ LVEDD ） and end systolic diameter （ LVESD ） before and after treatment were observed by ultrasonography.Result： Before PCI, there was no significant difference between two groups＇ LVESD and LVDD levels （P〉0.05）, after operation, the left ventricular function improvement of observation group was better than that of controlgroup.The platelet aggregation rate of used different inducers in observation group was lower than those of the contwl group, the differences were statistically significant （ P〈0.05 ） . Follow up for 3 months, the adverse events （ heart dysfunction, death, angina, reinfarction ） rate of observation group was lower than that of control group, the recanalization rate of observation group was 97.8%, higher than 82.2% of control group, the reperfusion and TIMI blood flow classification of observation group was better than those of control group, the differences were statistically significant （P〈0.05） .Conclusion： Acute myocardial infarction patients treated with Tirofiban before PCI, can improve the vessel recanalization rate and avoid post- operation platelet aggregation, promote the recovery of left ventricular function.
作者
刘秀兰
LIU Xiu-lan(Heze Municipal Hospital, Heze 274000, Chin)
出处
《中国医学创新》
CAS
2017年第23期21-25,共5页
Medical Innovation of China
