替罗非班联合PCI对老年急性心肌梗死患者心功能及左室重构的影响

Effect of tirofiban combined with PCI on cardiac function and left ventricular remodeling in elderly patients with acute myocardial infarction

目的观察替罗非班联合PCI对老年急性心肌梗死(AMI)患者心功能、心脏重构的影响。方法 2014年12月—2017年9月武汉亚洲心脏病医院心内科急诊收治并进行PCI治疗的AMI患者119例,回顾其治疗方案并分为常规接受PCI治疗的对照组(n=63)、接受替罗非班联合PCI治疗的观察组(n=56)。对比2组患者的心肌损伤、心功能、左心室重构情况差异。结果术后6、12 h,观察组患者血清CK-MB、α-HBD、LDH、c Tn I水平低于对照组(t_(术后6 h)=-8.798、-7.222、-7.113、-4.324,t_(术后12 h)=-12.974、-6.638、-11.370、-11.794,P均=0.000);心功能指标LVEF、CO、CI水平高于对照组(t_(术后6 h)=4.467、4.598、5.438,t_(术后12 h)=5.068、4.807、3.166,P均=0.000);左室重构指标LVS、LVD的水平低于对照组患者(t_(术后6 h)=3.386、3.050,t_(术后12 h)=5.377、5.020,P均=0.000)。结论老年AMI患者接受替罗非班联合PCI治疗,可有效减轻PCI术后心肌损伤并积极优化机体心功能、抑制左心室重构。

Objective To observe the effects of tirofiban combined with PCI on cardiac function and cardiac remodeling in elderly patients with acute myocardial infarction (AMI). Methods From December 2014 to September 2017,119 AMI patients were admitted to the Department of Cardiology of Wuhan Asian Heart Hospital and treated with PCI. The treatment regimen was reviewed and divided into control group (n = 63) receiving routine PCI treatment and observation group (n = 56) receiving tirofiban combined with PCI treatment. The differences of myocardial injury,cardiac function and left ventricular remodeling between the two groups were compared. Results The levels of serum CK-MB,α-HBD,LDH and cTnI in the observation group were lower than those in the control group at 6 and 12 hours after operation (6 h after surgery: t =-8. 798,t =-7. 222,t =-7. 113,t =-4. 324; 12 h after t =-12. 974,t =-6. 638,t =-11. 370,t =-11. 794,P = 0. 000); cardiac function indicators LVEF,CO,CI levels were higher than the control group (6 h: t = 4. 467,t = 4. 598,t = 5. 438; 12 h: t = 5. 068,t = 4. 807,t = 3. 166,P = 0. 000); left ventricular remodeling index LVS,LVD levels were lower than the control group (6 h after surgery: t = 3. 386,t = 3. 050; 12 h after surgery: t = 5. 377,t = 5. 020,P = 0. 000).Conclusion Tirofiban combined with PCI in elderly patients with AMI can effectively reduce myocardial injury after PCI,actively optimize cardiac function and inhibit left ventricular remodeling.