冠脉内替罗非班和山莨菪碱联合注射改善STEMI患者PCI术后心肌血流灌注的临床研究

Intracoronary injection of tirofiban combined with anisodamine improves myocardial perfusion in patients with STEMI after PCI

目的:分析冠脉内替罗非班和山莨菪碱联合注射改善急性ST段抬高型心肌梗死(STEMI)患者冠脉介入手术(PCI)术后心肌血流灌注的效果。方法:78例在本院接受PCI术治疗STEMI患者随机分为对照组及观察组,对照组接受常规PCI术治疗,观察组在PCI术中进行冠脉替罗非班和山莨菪碱注射,对比两组的心肌血流灌注情况。结果:观察组PCI术后即刻及PCI术后4h的QRS波时限值均小于对照组(P<0.05);观察组PCI术后^(99m)Tc-MIBI、^(18)F-FDG摄取量大于对照组(P<0.05);观察组PCI术后4h血清单核细胞趋化因子-1(MCP-1)、细胞凋亡抑制因子(sFas)、羧基端糖基化肽(Copeptin)、骨桥蛋白(OPN)、血管血友病因子(vWF)水平均低于对照组(P<0.05)。结论:冠脉内替罗非班和山莨菪碱联合注射可以优化STEMI患者PCI术后心肌血流灌注,具有积极的临床意义。

Objective： To analyze the effect of intracoronary injection of tirofiban combined with anisodamine on impro- ving myocardial perfusion in patients with STEMI after PCI. Methods： A total of 78 patients with acute ST segment elevation myocardial infarction （STEMI） who received PCI therapy in our hospital were randomly divided into control group and observa- tion group, control group accepted routine PCI treatment, observation group received intracoronary injection of tirofiban and anisodamine in PCI, and myocardial perfusion of two groups was compared. Results： QRS duration values of observation group the instant after PCI and 4 h after PCI were less than those of control group （P〈0.05）; 99mTc-MIBI and 18F-FDG intake of observation group after PCI were more than those of control group （P〈0.05） ; serum MCP-1, sFas, Copeptin, OPN and vWF levels of observation group 4 h after PCI were lower than those of control group （P〈0.05）. Conclusions： Intracoronary injec- tion of tirofiban combined with anisodamine can optimize myocardial perfusion in patients with STEMI after PCI, and has posi- tive clinical significance.