替罗非班对AMI患者介入治疗后炎症因子、内皮功能及心功能的影响

Effect of tirofiban on inflammatory factors,endothelial function and cardiac function after interventional therapy in AMI patients

目的:探讨替罗非班对急性心肌梗死(AMI)患者介入治疗后炎症因子、内皮功能及心功能的影响。方法:选取120例急性心肌梗死患者作为研究对象,均符合PCI手术指征,随机分为观察组60例与对照组60例。对照组患者于PCI术前、术后口服阿司匹林与氯吡格雷,观察组在对照组的基础上联用替罗非班。检测并比较两组患者的炎症因子、内皮功能及心功能指标。结果:治疗前,两组患者的超敏C反应蛋白(hs-CRP)、可溶性CD40配体(sCD40L)、肿瘤坏死因子-α(TNF-α)水平无统计学差异(P>0.05);治疗后,两组患者的hs-CRP分别为(5.01±1.95)mg/L、(9.41±2.48)mg/L,sCD40L分别为(1.88±0.25)ng/mL、(2.77±0.27)ng/mL,TNF-α分别为(8.86±2.18)ng/L、(15.52±2.78)ng/L,两组的hs-CRP、sCD40L、TNF-α水平均降低,且观察组各指标水平明显低于对照组(P<0.05)。治疗前,两组患者的一氧化氮(NO)、内皮素-1(ET-1)、血管性假血友病因子(vWF)水平均无统计学差异(P>0.05);治疗后,两组患者的NO分别为(82.48±11.57)μmol/L、(66.68±13.18)μmol/L,两组NO均升高,且观察组的NO高于对照组(P<0.05);治疗后,两组患者的ET-1分别为(55.03±6.58)ng/L、(66.17±5.42)ng/L,vWF分别为(66.17±5.88)×10^(-2)、(83.28±5.39)×10^(-2),两组的ET-1、vWF均降低,且观察组的ET-1、vWF低于对照组(P<0.05)。治疗前,两组患者的左室射血分数(LVEF)、左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)均无统计学差异(P>0.05);治疗后,观察组的LVEF、LVESD、LVEDD分别为(63.87±6.43)%、(38.27±4.66)mm、(43.63±7.61)mm,其中LVEF高于同期对照组,LVESD、LVEDD低于同期对照组,差异均有统计学意义(P<0.05)。结论:替罗非班能够有效改善AMI患者介入治疗后的炎症因子、内皮功能及心功能。

Objective： To investigate the effect of tironon on inflammatory factors, endothelial function and cardiac function after interventional therapy in AMI patients. Methods： A total of 120 patients with acute myocardial infarction in our hospital were selected as the research objects, and all of them were in line with the indications of PCI operation. They were randomly divided into the observation group （60 cases） and the control group （60 cases）. The control group were treated with aspirin and clopidogrel before and after PCI, and the observation group were treated with the method based on the use of tirofiban. Inflammatory factors, endothelial function and cardiac function index were detected and compared between the two groups. Results： Before treatment, there was no significant difference in hs-CRP, sCD40L and TNF-α levels in the two groups （ P 〉 0.05）. After treatment, the hs-CRP of the two groups were （5.01±1.95） mg/L, （9.41±2.48） mg/L, sCD40L were （1.88± 0.25） ng/mL, （2.77±0.27） ng/mL, TNF-α were （8.86±2.18） ng/L, （15.52±2.78 ng/L） ng/L, respectively. The levels of hs-CRP, sCD40L and TNF-α in the two groups all decreased, and the level of each index in the observation group was significantly lower than that of the control group （ P 〈0.05）. There was no significant difference in NO, ET-1 and vWF levels between the two groups before treatment （ P 〉0.05）. After treatment, the NO of the two groups were （82.48±11.57） umol/L and （66.68±13.18） umol/L, respectively. The two groups of NO were both elevated, and the NO of the observation group was significantly higher than that of the control group （ P 〈0.05）. After treatment, the ET-1 of the two groups were （55.03±6.58） ng/L, （66.17±5.42） ng/L, and vWF were （66.17±5.88） x 10 - 2, （83.28±5.39） x10 - 2, respectively. The ET-1 and vWF of the two groups all decreased, and the ET-1 and vWF of the observation group were significantly lower than those of the control group （ P 〈0.05）. There was no significant difference in LVEF, LVESD and LVEDD between the two groups before treatment （ P 〉0.05）. After treatment, the LVEF, LVESD and LVEDD of the observation group were （63.87±6.43）%, （38.27±4.66） mm and （43.63±7.61） mm, respectively. The LVEF of the observation group was significantly higher than that of the control group, and the LVESD and LVEDD were significantly lower than that of the control group （ P 〈0.05）. Conclusion： Tirofiban can effectively improve the inflammatory factors, endothelial function and cardiac function of AMI patients after interventional therapy.