欣维宁联合山莨菪碱对介入术后ST段抬高型心肌梗死患者心功能恢复及内皮功能保护的作用

Role of tirofiban combined with anisodamine injection in protecting myocardial function recovery and endothelial function in patients with STEMI after PCI

目的探讨欣维宁联合山莨菪碱注射液对经皮冠状动脉介入(percutaneous coronary intervention,PCI)术后急性ST段抬高型心肌梗死患者心功能恢复及内皮功能保护作用。方法选取医院2016-07至2018-02期间收治的116例STEMI患者作为研究对象,按照简单随机法将患者分为两组均行PCI术治疗,对照组予以欣维宁,观察组予以欣维宁+山莨菪碱。比较两组患者治疗前后心肌再灌注、心功能水平、血管内皮损伤标志物变化情况,及术后6个月不良心血管事件发生情况。结果观察组患者术后2 h ST段回落率、cTFC、心肌灌注分级优于对照组(P<0.05)。两组患者术后左心室舒张末内径(left ventricular end-diastolic diameter,LVEDD)、左心室射血分数(left ventricular eject force,LVEF)较术前均有改善(P<0.05);在T1、T2,观察组患者LVEDD、LVEF优于对照组(P<0.05)。两组患者治疗后VEGF、ET-1水平低于治疗前,NO水平高于治疗前(P<0.05);观察组治疗后血管内皮生长因子(VEGF)、血浆内皮素-1(ET-1)水平低于对照组,一氧化氮(NO)水平高于治疗组(P<0.05)。两组PCI术后6个月内不良心血管事件发生率分别为17.24%(10/58)、3.45%(2/58),观察组不良心血管事件发生率低于对照组,差异有统计学意义(P<0.05)。结论欣维宁联合山莨菪碱注射液可改善STEMI患者PCI术后心肌灌注情况,同时提高心功能,保护血管内皮,降低不良心血管事件发生风险。

Objective To investigate the protective role of tirofiban combined with anisodamine injection in myocardial function recovery and endothelial function in patients with STEMI after PCI.Methods One hundred and sixteen cases of STEMI patients treated in our hospital between July 2016 and February 2018 were selected as the subjects.Using the simple random method,the patients were divided into the control group and the observation group.Both groups were treated with PCI,but the control group was given tirofiban,while the observation group received tirofiban+anisodamine.The changes of myocardial reperfusion,cardiac function,vascular endothelial injury markers and adverse cardiovascular events were compared between the two groups before and after treatment.Results The 2 h ST segment drop rate,cTFC and the myocardial perfusion grade of the observation group were better than those of the control group(P<0.05).The left ventricular end-diastolic diameter(LVEDD),left ventricular ejection force(LVEF)and left ventricular end-diastolic diameter(LVEDD)were improved after operation in both groups(P<0.05).At T1 and T2,the LVEDD and LVEF of the observation group were better than those of the control group(P<0.05).After treatment,the levels of vascular endothelial growth factor and ET-1 in the two groups were lower,but the levels of NO were higher(P<0.05).After treatment,the levels of vascular endothelial growth factor and ET-1 in the observation group were lower than those in the control group(荒唐的表达).The incidence of adverse cardiovascular events within 6 months after PCI was 17.24%(10/58)in the observation group and 3.45%(2/58)in the control group.Conclusions Tirofiban combined with anisodamine injection can boost myocardial perfusion in patients with STEMI,improve cardiac function,protect vascular endothelium and reduce the risk of adverse cardiovascular events.