前列地尔联合替罗非班治疗急性非ST段抬高型心肌梗死行PCI术患者的疗效及对其心肌微循环相关指标的影响

Effect of alprostadil combined with tirofiban on patients with acute non-ST-segment elevation myocardial infarction and myocardial microcirculation undergoing PCI operation

目的 探讨前列地尔联合替罗非班治疗急性非ST段抬高型心肌梗死（NSTEMI）行急诊经皮冠脉介入治疗术（PCI）患者的疗效及对其心肌微循环相关指标的影响.方法 选取2014年1月至2016年2月NSTEMI患者68例,随机数表法分为对照组（n=34）和研究组（n=34）.对照组采用氯吡格雷＋阿司匹林,并静脉滴注氯化钠注射液,研究组联合应用前列地尔与替罗非班.对比两组冠脉血流速度、心肌灌注情况（TMPG）、治疗前后左心室射血分数（LVEF）变化情况,并统计两组不良反应发生情况.结果 研究组LAD及RCA血流速度小于对照组,差异有统计学意义（P＜0.05）,两组LCX血流速度对比差异未见统计学意义（P＞0.05）;研究组TMPG3级（88.24%）高于对照组（67.65%）,差异有统计学意义（P＜0.05）;治疗前两组LVEF对比差异未见统计学意义（P＞0.05）,经治疗,研究组高于对照组,差异有统计学意义（P＜0.05）;研究组不良反应发生率（11.76%）与对照组（14.70%）对比,差异未见统计学意义（P＞0.05）.结论 联合采用前列地尔与替罗非班治疗行PCI术的急性非ST段抬高型心肌梗死患者效果显著,可有效改善其心肌微循环状态,且安全性较高.

Objective To discuss the impact of alprostadil combined with tirofiban on patients suffering acute non-ST-segment elevation myocardial infarction and myocardial microcirculation undergoing PCI operation.Methods Sixty-eight cases in hospital from January 2014 to February 2016 were randomly devided into control group （n=34） and experiment group （n=34）. The control group were treated with clopidogrel＋aspirin, and intravenous infusion of saline simutaneously, the experiment group were treated with alprostadil and tirofiban. Coronary flow velocity, myocardial perfusion （TMPG） and left ventricular ejection fraction （LVEF） were compared between the two groups, besides, the adverse reactions were observed.Results The blood flow rate of LAD and RCA in the experiment group was lower than that in the control group,the difference was significant （P〈0.05）,there was no significant difference in LCX blood flow velocity between the two groups （P〉0.05）; the level of TMPG3 （88.24%） was significantly higher than that of the control group （67.65%） （P〈0.05）; the LVEF level did not change significantly before and after treatment （P〉0.05）, after treatment, the LVEF level in experiment group was significantly higher than that in control group （P〈0.05）; there was no significant difference in the incidence of adverse reactions between the experiment group （11.76%） and the control group （14.70%）（P〉0.05）.Conclusions The effect of alprostadil combined with tirofiban on patients with acute non-ST-segment elevation myocardial infarction and myocardial microcirculation undergoing PCI operation is significant, which can effectively improve their myocardial microcirculation with high security.