冠状动脉内注射替罗非班在急性ST段抬高型心肌梗死冠脉介入手术治疗中对血流动力学的影响研究

Effect of Intravascular Injection of Tirofiban on Hemodynamics in Treatment of Acute ST Segment Elevation Myocardial Infarction by Percutaneous Coronary Intervention

目的:为了提高急性ST段抬高型心肌梗死(STEMI)经皮冠状动脉介入(PCI)治疗效果,分析冠状动脉内注射替罗非班对血流动力学的影响。方法:选取2014年6月-2017年6月本院收治的急性STEMI患者800例。通过抽签的方式将其分为对照组和观察组,各400例。对照组单纯接受PCI治疗,观察组在接受PCI的同时行冠状动脉内注射替罗非班治疗。比较两组术后TIMI血流分级、ST段回落率,比较两组治疗前后的左室射血分数和左室舒张末期内径。结果:术后,两组左室射血分数、左室舒张末期内径均优于术前,且观察组均优于对照组,比较差异均有统计学意义(P<0.05);观察组术后TIMI血流分级以及ST段回落率均明显优于对照组,比较差异均有统计学意义(P<0.05)。结论:急性STEMI患者在接受PCI术的同时进行冠状动脉内注射替罗非班治疗,不仅可以在提高冠状动脉血流的同时增加对缺血区的心肌再灌注,还可以改善心室功能,疗效确切,值得推广和应用。

Objective:To improve the effect of percutaneous coronary intervention(PCI)for acute ST segment elevation myocardial infarction(STEMI),the effect of intra coronary injection of Tirofiban on hemodynamics was analyzed.Method:A total of 800 patients with acute STEMI in our hospital from June 2014 to June 2017 were selected.They were divided into control group and observation group by the way of drawing,400 cases in each group.The control group was treated with PCI alone,and observation group was treated with PCI and injected Tirofiban in the coronary artery.The TIMI blood flow classification and the ST segment drop rate after treatment between two groups were compared,the left ventricular ejection fraction and left ventricular end diastolic diameter before and after treatment between two groups were compared.Result:After operation,the left ventricular ejection fraction and left ventricular end diastolic diameter of two groups were all better than those of before operation,and observation group were better than those of control group,the differences were statistically significant(P<0.05).The TIMI blood flow classification and the ST segment fall rate in observation group were significantly better than those of control group,the differences were statistically significant(P<0.05).Conclusion:In patients with acute STEMI,coronary artery injection of Tirofiban during PCI can not only increase coronary blood flow,but also improve myocardial reperfusion in ischemic area,and improve ventricular function,which is effective and worthy of promotion and application.