盐酸替罗非班联合心血管介入治疗急性心肌梗死患者的临床效果与安全性分析

Clinical effect and safety analysis of tirofiban hydrochloride combined with cardiovascular intervention in the treatment of patients with acute myocardial infarction

目的:探究盐酸替罗非班联合心血管介入治疗急性心肌梗死的临床效果以及安全性。方法:2018年1-12月收治急性心肌梗死患者80例,随机分为两组,各40例。两组患者在术前2 h内口服300 mg阿司匹林肠溶片以及300 mg氯吡格雷,于术后口服氯吡格雷(75 mg/d)以及阿司匹林肠溶片(100 mg/d),在PCI术中通过鞘管侧管注入肝素钠(100 U/kg)。观察组在实施PCI术前30 min内经静脉给予盐酸替罗非班,在开始前5 min内,按照10μg/kg的剂量,以静脉推注的方式注入,将血药浓度维持在0.15μg/(kg·min),持续泵入24~36 h,术后给予患者低分子肝素钙5000 U,皮下注射,每12 h注射1次,持续3~5 d。比较两组治疗效果。结果:观察组患者术后12 h CK-MB水平低于对照组,差异有统计学意义(P<0.05)。两组1级患者数量比较,差异无统计学意义(P>0.05)。观察组2级患者比对照组少,3级患者比对照组多,差异有统计学意义(P<0.05)。两组PCI术后TMPG灌注2级比较,差异无统计学意义(P>0.05)。观察组TMPG灌注1级患者少于对照组,TMPG灌注3级患者多于对照组,差异有统计学意义(P<0.05)。观察组不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。结论:盐酸替罗非班联合心血管介入治疗急性心肌梗死效果显著,可以提高患者灌注情况,并且降低心血管事件发生率,安全性较高。

Objective:To explore the clinical effect and safety of tirofiban hydrochloride combined with cardiovascular intervention in the treatment of patients with acute myocardial infarction.Methods:80 patients with acute myocardial infarction were selected from January to December 2018,they were randomly divided into two groups with 40 cases in each group.Patients in the two groups were given 300 mg aspirin enteric coated tablets and 300 mg clopidogrel within 2 hours before operation.The clopidogrel(75 mg/d)and aspirin enteric coated tablets(100 mg/d)were given orally after surgery,heparin sodium needle(100 U/kg)was injected through the sheath side tube during PCI.In the observation group,tirofiban hydrochloride was given intravenously 30 minutes before PCI,and 10μg/kg of tirofiban hydrochloride was given intravenously 5 minutes before PCI.The concentration of tirofiban was maintained at 0.15μg/(kg·min)and pumped continuously for 24~36 hours.After PCI,5000 U of low molecular weight heparin calcium needle was given subcutaneously once every 12 hours for 3~5 days.We compared the therapeutic effect of the two groups.Results:The CK-MB level was lower in the observation group than in the control group at 12 h after surgery,the difference was statistically significant(P<0.05).There was no significant difference in the number of grade 1 patients between the two groups(P>0.05).The observation group had fewer grade 2 patients and more grade 3 patients than the control group,the difference was statistically significant(P<0.05).There was no significant difference in TMPG perfusion level 2 between the two groups after PCI(P>0.05).Patients with TMPG perfusion level 1 in the observation group were less than those in the control group,and patients with TMPG perfusion level 3 were more than those in the control group,the differences were statistically significant(P<0.05).The overall incidence of adverse reactions in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion:Tirofiban hydrochloride combined with cardiovascular intervention is effective in the treatment of acute myocardial infarction,which can improve the perfusion status of patients,reduce the incidence of cardiovascular events,and have higher safety.