替罗非班不同用药方法对老年急性ST段抬高型心肌梗死血栓抽吸患者不良心血管事件的影响

Effects of Tirofiban on Adverse Cardiovascular Events in Elderly Patients with STEMI Thrombus Aspiration

目的:探讨替罗非班不同用药方法对老年急性ST段抬高型心肌梗死(STEMI)血栓抽吸患者不良心血管事件的影响。方法:选择2016年8月-2019年12月河南科技大学第一附属医院收治的老年STEMI血栓抽吸患者120例,根据抽签法将其分为两组,每组各60例。对照组静脉推注盐酸替罗非班注射液,观察组于闭塞或重度狭窄冠状脉开口处注射注盐酸替罗非班注射液,比较两组不良心血管事件发生率、心功能恢复情况、ST段回落程度。结果:随访6个月内,观察组不良心血管事件总发生率6.67%低于对照组20.00%,差异有统计学意义(P<0.05);治疗后,两组左心室射血分数(LVEF)水平较治疗前上升,左心室舒张末内径(LVEDd)水平较治疗前下降,且观察组水平优于对照组,差异有统计学意义(P<0.05);治疗1周后,观察组ST段总回落率98.33%高于对照组86.67%,差异有统计学意义(P<0.05)。结论:通过闭塞或重度狭窄冠脉开口处注射替罗非班可有效降低老年STEMI血栓抽吸患者不良心血管事件发生率,改善心功能,提高ST段回落程度。

Objective: To investigate the effect of tirofiban on adverse cardiovascular events in elderly patients with acute myocardial infarction(STEMI) and thrombus aspiration. Methods: 120 elderly patients with STEMI thrombus in the hospital from Augus 2016 to December 2019 were selected and divided into two groups, with 60 in each group. In the control group, tirofiban hydrochloride was injected intravenously, and in the observation group, tirofiban hydrochloride was injected at the opening of occluded or severe stenosis coronary artery. The incidence of adverse cardiovascular events, the recovery of cardiac function and the degree of ST segment decline were compared between the two groups. Results: Within 6 months of follow-up, the total incidence of adverse cardiovascular events in the observation group was 6.67%, which was lower than that in the control group(20.00%). The difference was statistically significant(P<0.05). After treatment, the level of LVEF in the two groups increased, the level of LVEDd decreased, and the level of the observation group was better than that of the control group. The difference was statistically significant(P<0.05). After 1 week of treatment, the total fall rate of ST segment in the observation group was 98.33%, which was higher than that in the control group. The difference was statistically significant(P<0.05). Conclusion: Tirofiban injection at the opening of occlusion or severe stenosis coronary artery can effectively reduce the incidence of adverse cardiovascular events, improve the cardiac function, and improve the degree of ST segment regression.