替罗非班联合瑞替普酶溶栓对老年ST段抬高型心肌梗死患者心功能指标变化、血清因子水平的影响

Effect of Tirofiban combined with thrombolytic therapy of Reteplase on the changes of cardiac parameters, levels of serum factors in elderly patients with ST-elevation myocardial infarction

目的探讨替罗非班联合瑞替普酶溶栓对老年ST段抬高型心肌梗死患者心功能指标变化、血清因子水平的影响。方法选取2013年12月~2016年3月就诊于解放军第一七五医院的ST段抬高型心肌梗死老年患者106例,按照随机数字表法将其分为研究组和对照组,各53例。对照组给予瑞替普酶溶栓干预,研究组给予替罗非班联合瑞替普酶溶栓干预。观察两组患者左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)、心搏出量(SV)等心功能指标变化,血清超敏C反应蛋白(hs-CRP)、同型半胱氨酸(Hcy)及补体3(C3)水平和并发症发生率。结果两组患者治疗前SV、LVEDD、LVESD、LVEF水平比较,差异无统计学意义(P>0.05);治疗后两组患者LVEDD、LVESD水平均较治疗前显著降低,且研究组患者治疗后LVEDD、LVESD水平较对照组显著降低(P<0.05);治疗后两组患者SV、LVEF水平均较治疗前显著升高,且研究组患者治疗后SV、LVEF水平较对照组显著升高(P<0.05)。两组患者治疗前hs-CRP、Hcy、C3水平比较,差异无统计学意义(P>0.05);治疗后两组患者hs-CRP、Hcy、C3水平均较治疗前显著降低,研究组患者治疗后hs-CRP、Hcy、C3水平较对照组显著降低(P<0.05)。研究组并发症发生率为9.43%,较对照组(43.40%)显著降低(P<0.05)。结论采用替罗非班联合瑞替普酶溶栓能够有效改善心功能,降低hs-CRP、Hcy、C3水平,减少并发症。

Objective To discuss the effects of Tirofiban combined with thrombolytic therapy of Reteplase on the changes of cardiac parameters, levels of serum factors in elderly patients with ST-elevation myocardial infarction. Methods One hundred and six cases of elderly patients with ST-elevation myocardial infarction treated in PLA 175th Hospital from December 2013 to March 2016 were selected and divided into study group and control group according to the random digital table method, with 53 patients in each group. The control group was given thrombolytic therapy of Reteplase, while the study group was given Tirofiban combined with thrombolytic therapy of Reteplase. The changes of cardiac parameters such as left ventricular end systolic diameter （LVESD）, left ventricular diastolic end diastolic diameter （LVEDD）, left ventricular shoot ejection fraction （LVEF）, stroke volume （SV） in the two groups were observed, as well as the serum high sensitive C reactive protein （hs-CRP）, homocysteine （Hcy） and complement 3 （C3） levels and the incidence rate of complications. Results There were no significant differences in the levels of SV, LVEDD, LVESD and LVEF between the two groups before treatment （P 〉 0.05）. The LVEDD and LVESD in the two groups after treatment were significantly decreased compared with those before treatment, which in the study group after treatment were significantly lower than those in the control group （P 〈 0.05）. The levels of SV and LVEF in the two groups after treatment were significantly increased compared with those before treatment （P 〈 0.05）, which in the study group after treatment were significantly higher than those in the control group （P 〈 0.05）. There were no significant differences in the levels of hs-CRP, Hcy, and C3 between the two groups before treatment （P 〉 0.05）. The levels of hs-CRP, Hcy, C3 in the two groups after treatment were significantly decreased compared with those before treatment, which in the study group were significantly lower than those in the control group （P 〈 0.05）. The incidence rate of complications in the study group was 9.43%, which was significantly lower than that in the control group （43.40%） （P 〈 0.05）. Conclusion The application of Tirofiban combined with thrombolytic therapy of Reteplase can effectively improve the heart function, decrease the levels of hs-CRP, Hcy, C3 and reduce complications.