摘要
目的探讨PCI术前应用替罗非班对急性心肌梗死(AMI)患者微血管阻塞和左心室功能的影响。方法抽取2019年9月至2020年9月临汾市中心医院收治的92例AMI患者,按照随机数字表法将其分为观察组和对照组,每组46例。两组AMI患者均行经皮冠状动脉介入治疗(PCI),观察组在PCI术前采用替罗非班治疗,分析替罗非班对患者微血管阻塞及左心室功能的影响。结果治疗后,两组QT间期离散度(QTd)较治疗前降低,峰值强度(PI)、曲线下面积(AUC)较治疗前升高,且观察组QTd低于对照组,PI、AUC高于对照组(P<0.05)。治疗后,观察组ST段降低幅度高于对照组,酶峰时间低于对照组(P<0.05)。与治疗前比较,治疗后两组活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)、D二聚体(D-D)水平均升高,纤维蛋白原含量(FIB)降低(P<0.05);且观察组D-D、APTT、PT、TT高于对照组,FIB低于对照组(P<0.05)。与治疗前比较,治疗后两组左心室射血分数(LVEF)均升高,左心室收缩末期容积(LVESVI)、室壁运动积分指数(WMSI)降低(P<0.05),且观察组LVESVI、WMSI低于对照组,LVEF高于对照组(P<0.05)。与治疗前比较,治疗后两组单核细胞血小板聚集体(MPA)、溶酶体膜糖蛋白(CD63)、血小板α颗粒表面膜糖蛋白(CD62P)均降低(P均<0.05),且观察组MPA、CD63、CD62均低于对照组(P均<0.05)。结论在AMI患者PCI术前应用替罗非班治疗后,患者微血管循环及凝血功能均得到显著改善,心肌损伤明显降低,心功能恢复较好。
Objective To investigate the effects of tirofiban before PCI on microvascular obstruction and left ventricular function in patients with acute myocardial infarction(AMI).Methods A total of 92 patients with AMI admitted to Linfen Central Hospital from September 2019 to September 2020 were selected,and they were divided into observation group and control group by random number table method,with 46 cases in each group.All patients in two group underwent percutaneous coronary intervention(PCI).Patients in observation group were treated with tirofiban before PCI.The effects of tirofiban on microvascular obstruction and left ventricular function were analyzed and compared.Results After treatment,QT dispersion(QTd)interval decreased,peak intensity(PI)and area under curve(AUC)increased in both groups,compared with before treatment(P<0.05).After treatment,QTd in observation group was lower than that in control group,PI and AUC were higher than those in control group(P<0.05).After treatment,the decrease of ST segment in observation group was higher than that in the control group,and the enzyme peak time was lower than that in control group(P<0.05).Compared with before treatment,activated partial thromboplastin time(APTT),prothrombin time(PT),thrombin time(TT),D-dimer(D-D)levels were increased and fibrinogen(FIB)was decreased in both groups after treatment(P<0.05).After treatment,D-D,APTT,PT and TT in observation group were higher than those in control group,while FIB was lower than that in control group(P<0.05).Compared with before treatment,left ventricular ejection fraction(LVEF)increased,left ventricular end-systolic volume(LVESVI)and Wall Motion Score Index(WMSI)decreased in both groups after treatment(P<0.05).After treatment,LVESVI and WMSI in observation group were lower than those in control group,while LVEF was higher than that in control group(P<0.05).Compared with before treatment,monocyte platelet aggregates(MPA),lysosome intact membrane protein(CD63),and alpha-granular membrane protein(CD62P)decreased in both groups after treatment(P<0.05),and MPA,CD63,and CD62P in observation group were lower than those in control group(all P<0.05).Conclusions Tirofiban before PCI can significantly improve microvascular circulation and coagulation function,and significantly reduce myocardial damage,with good recovery of cardiac function in AMI patients.
作者
史志明
张丽霞
张静
冯炎青
张晋峰
吕孟妍
Shi Zhiming;Zhang Lixia;Zhang Jing;Feng Yanqing;Zhang Jinfeng;Lyu Mengyan(Department of Cardiology,Linfen Central Hospital,Linfen 041000,China)
出处
《中国实用医刊》
2021年第19期110-114,共5页
Chinese Journal of Practical Medicine
关键词
心肌梗死
替罗非班
微血管阻塞
左心室功能
Myocardial infarction
Tirofiban
Microvascular obstruction
Left ventricular function
