血栓抽吸联合替罗非班对急性ST段抬高型心肌梗死临床效果及心肌再灌注分析

Clinical Effect of Thrombus Aspiration Combined with Tirofiban on Acute ST-segment Elevation Myocardial Infarction and Myocardial Reperfusion

目的 观察急性ST段抬高型心肌梗死应用血栓抽吸与替罗非班联合治疗的效果及心肌再灌注情况。方法 临床资料采集该院2017年7月—2018年7月心血管科治疗的108例急性STEMI患者,按不同治疗方案分2组,每组54例,对照组行PCI术治疗,观察组在PCI术中行血栓抽吸+替罗非班治疗,比较两组心功能及心肌再灌注、预后情况。结果 观察组治疗后LVEF(46.88±5.88)%、LVESD(39.85±5.26)mm、LVEDD(51.33±4.65)mm相较于对照组(36.78±4.86)%、(49.67±5.71)mm、(65.13±5.22)mm改善显著(t=9.729 2,t=9.295 0,t=14.506 1,P<0.05),且观察组治疗后BNP(128.37±18.92)pg/mL、cTnI(0.65±0.11)μg/L相较于对照组(285.51±38.52)pg/mL、(2.31±1.12)μg/L水平更低(t=26.907 1,t=10.839 3,P<0.05);观察组治疗后心肌再灌注Ⅲ级所占比75.93%相较于对照组53.70%更高(χ~2=5.846 6,P<0.05);观察组不良心血管事件相较于对照组18.52%更低(χ~2=4.285 0,P<0.05)。结论 急性ST段抬高型心肌梗死应用血栓抽吸与替罗非班联合治疗能促进心功能进一步改善,并改善心肌再灌注,降低心血管危险事件发生,安全有效。

Objective To observe the effect of thrombus aspiration combined with tirofiban and myocardial reperfusion in patients with acute ST-segment elevation myocardial infarction. Methods Clinical data were collected from 108 patients with acute STEMI who underwent cardiovascular therapy from July 2017 to July 2018 in our hospital. According to different treatment regimens, they were divided into 2 groups, with 54 patients in each group. The control group underwent PCI and the observation group was in PCI. During the operation, thrombectomy and tirofiban were used to compare cardiac function, myocardial reperfusion and prognosis. Results After treatment, the improvement of LVEF (46.88±5.88)%, LVESD (39.85±5.26) mm, LVEDD (51.33±4.65) mm in the observation group were better than that in the control group (36.78±4.86)%,(49.67±5.71) mm,(65.13±5.22) mm (t=9.729 2, t=9.295 0, t=14.506 1,P<0.05), After treatment, BNP (128.37±18.92) pg/mL and cTnI (0.65±0.11)μg/L in the observation group were lower than those in the control group (285.51±38.52) pg/mL and (2.31±1.12)μg/L (t=26.907 1,t=10.839 3,P<0.05). The proportion of myocardial reperfusion grade Ⅲ after treatment in the observation group was 75.93%, which was higher than that in the control group (53.70%)(χ^2=5.846 6,P<0.05). The adverse cardiovascular events in the observation group were lower than that in the control group (18.52%)(χ^2=4.285 0,P<0.05). Conclusion The combination of thrombus aspiration and tirofiban in acute ST-segment elevation myocardial infarction can promote further improvement of cardiac function, improve myocardial reperfusion, and reduce cardiovascular risk events, which is safe and effective.