替罗非班对急性非ST段抬高心肌梗死患者血清肌钙蛋白T水平及近期预后的影响

Influence of tirofiban on the serum cardiac troponin T level and short term prognosis in patients with acute non ST segment elevation myocardial infarction

目的:观察和分析替罗非班对急性非ST段抬高心肌梗死(non ST segment elevation myocardial infarction,NSTEMI)患者血清肌钙蛋白T(cardiac troponin T,c Tn T)水平及近期预后的影响。方法:选取116例NSTEMI患者作为研究对象,将其随机分为观察组和对照组,对照组患者应用口服阿司匹林、氯吡格雷及皮下注射低分子肝素钙治疗,观察组患者在对照组疗法基础上加用替罗非班静脉溶栓。对两组患者治疗60 d内的主要心脏不良事件(major adverse cardiac events,MACE)发生率进行观察和比较;并对两组患者入院时、治疗12 h、治疗24 h的血清c Tn T水平进行检测和比较。结果:观察组患者随访期内的MACE总发生率显著低于对照组,差异有统计学意义(P<0.05)。在治疗12 h和治疗24 h两个时点,观察组患者的血清c Tn T水平均显著低于对照组,差异均有统计学意义(P<0.05)。结论:在NSTEMI患者的治疗中加用替罗非班静脉溶栓,能够改善患者的近期预后,减轻患者的心肌损害,具有更好的临床疗效。

Objective To observe and analyze the influence of tirofiban on the serum cardiac troponin T （ cTnT） level and shortterm prognosis in patients with acute non ST segment elevation myocardial infarction（ NSTEM I）. Methods： 116 patients with NSTEMIwere selected as the research subjects,and randomly divided into the observation group and the control group. The patients in the controlgroup were treated with oral aspirin and clopidogrel combined with subcutaneous injection of low molecular weight heparin, while the patientsin the observation group were treated with intravenous thrombolysis of tirofiban on the basis of the therapy of the control group.The incidence of the major adverse cardiac events （M ACE） during 60 d of the patients in the two groups were observed and compared.The serum cTnT levels on admission, 12 h of the treatm ent,24 h of the treatment of the patients in the two groups were detected andcompared. Results： The overall incidence of MACE of the patients in the observation group during the follow-up period was significantlylower than that in the control group, the difference was statistically significant （ P 〈 0. 05 ） . At the time points of 12 h of the treatmentand 24 h of the treatment, the serum cTnT levels of the patients in the observation group were significantly lower than those in the controlgroup, the differences were statistically significant （P 〈 0. 0 5 ）. Conclusion： In the treatment of patients with NSTEMI,the applicationof combination with intravenous thrombolysis of tirofiban can improve the short-term prognosis of patients, reduce the myocardialdamage in patients and has better clinical curative effects.