盐酸替罗非班治疗冠心病的疗效及对同型半胱氨酸水平的影响

Effect of tirofiban hydrochloride in the treatment of coronary heart disease and its influence on homocysteine level

目的 探讨盐酸替罗非班治疗冠心病患者的临床疗效及其对同型半胱氨酸水平的影响.方法选取冠心病患者92例为研究对象,采用随机数字表法分为观察组和对照组,各46例.对照组行早期经皮冠状动脉介入手术后给予常规治疗,观察组在对照组治疗基础上加用盐酸替罗非班治疗,比较两组临床疗效及同型半胱氨酸水平的变化.结果 观察组总有效率为95.65%,高于对照组的82.61%,差异有统计学意义（χ2=4.039,P〈0.05）.观察组治疗后同型半胱氨酸水平为（5.38±1.02）μmol/L,低于对照组的（7.27±1.19）μmol/L,差异有统计学意义（t=8.179,P〈0.01）.治疗后,观察组心功能指标[每分输出量（CO）（4.96±0.98）L/min、射血分数（EF）（62.48±11.16）%及每搏量（SV）（86.37±11.47）mL],均高于对照组心功能指标[CO（4.51±0.92）L/min、EF（55.84±10.39）%及SV（79.72±10.42）mL],差异均有统计学意义（t=2.271、2.954、2.911,均P〈0.05）.治疗后,观察组hs-CRP[（4.25±1.32）mg/L]及纤维蛋白原（Fib）水平[（3.14±0.73）g/L],均低于对照组的hs-CRP[（6.31±1.15）mg/L]及Fib水平[（3.64±0.78）g/L],差异均有统计学意义（t=7.981、3.174,均P〈0.01）.结论 盐酸替罗非班能够有效降低冠心病患者同型半胱氨酸水平,减轻心肌缺血病变程度,降低Fib及hs-CRP水平,降低血栓形成及炎性反应对患者产生的危害程度.

Objective To investigate the effect of tirofiban hydrochloride in the treatment of coronary heart disease and its influence on homocysteine level.Methods 92 patients with coronary heart disease were selected as research subjects.They were randomly divided into the observation group and the control group,46 cases in each group.The control group was treated with anti-thrombotic,nitrates and other conventional western medicine.The observation group was treated with tirofiban hydrochloride based on the conventional treatment.Results The total effective rate of the observation group was 95.65%,which was higher than 82.61% of the control group,the difference was significant （χ2=4.039,P〈0.05）.And the homocysteine level in the observation group was （5.38±1.02）μmol/L,which was lower than （7.27±1.19）μmol/L in the control group,the difference was statistically significant （t=8.179,P〈0.01）.After treatment,the cardiac function CO level[（4.96±0.98）L/min],EF level[（62.48±11.16）%]and SV level[（86.37±11.47）mL]in the observation group were higher than those in the control group,the differences were statistically significant （t=2.271,2.954,2.911,all P〈0.05）.After treatment,the hs-CRP level[（4.25±1.32）mg/L]and Fib level[（3.14±0.73）g/L] in the observation group were lower than those in the control group,the differences were statistically significant （t=7.981,3.174,all P〈0.01）.ConclusionTirofiban hydrochloride in the treatment of coronary heart disease can effectively contribute to the reduction of homocysteine levels and alleviate atherosclerosis lesion progression,not only can reduce severity of myocardial ischemia and fibrinogen and high-sensitivity C-reactive protein levels,but also can reduce the thrombosis and inflammation produced by the degree of harm to the patients.