替罗非班联合美托洛尔治疗急性心肌梗死的疗效观察

Clinical observation of tirofiban combined with metoprolol in treatment of acute myocardial infarction

目的探讨替罗非班联合美托洛尔治疗心肌梗死患者的临床效果。方法选取2017年6月—2019年6月在周口豫东医院治疗的心肌梗死患者118例,随机分为对照组和治疗组,每组各59例。对照组患者口服酒石酸美托洛尔片,前期剂量6.25 mg/次,2~3次/d,根据患者病情增加药量,每次增加6.25~12.5 mg,最大剂量50~100 mg,2次/d,两周为1个疗程。治疗组在对照组的基础上静脉滴注盐酸替罗非班氯化钠注射液,初始剂量8μg/kg,用药后未见不良反应者调整滴速4μg/(kg·h),维持治疗24 h,连续治疗2周。观察两组患者临床疗效,同时比较治疗前后两组患者收缩压、舒张压、心率指标、心功能和不良反应。结果治疗后,对照组和治疗组总有效率分别为67.80%和94.92%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组收缩压、舒张压、心率水平显著下降,且治疗组各项标准均优于对照组(P<0.05)。治疗后,两组心功能指标明显改善,而治疗组患者左室舒张末数(LVEDD)、左心室收缩末期内径(LVESD)指标均显著低于对照组(P<0.05),心脏指数(CI)、左心室射血分数(LVEF)、心输血量(CO)高于对照组(P<0.05)。治疗期间,治疗组的不良事件发生率明显低于对照组(P<0.05)。结论替罗非班联合美托洛尔治疗心肌梗死患者效果显著,有利于调节和改善患者左心室射血分数,安全性较高。

Objective To investigate the clinical effect of tirofiban combined with metoprolol in treatment of acute myocardial infarction. Methods Patients(118) with acute myocardial infarction in Zhoukou Yudong Hospital from June 2017 to June 2019 were randomly divided into control and treatment groups, and each group had 59 cases. Patients in the control group were po administered with Metoprolol Tartrate Tablets, the prophase dosage was 6.25 mg/time, 2—3 times daily, then the dosage was increased according to the patient’s condition with 6.25 — 12.5 mg each time, and the maximum dosage was 50—100 mg, twice daily. Two weeks was as a course of treatment. Patients in the treatment group were iv administered with Tirofiban Hydrochloride and Sodium Chloride Injection on the basis of the control group, and the initial dosage was 8 μg/kg. If there was no adverse reaction, the dropping rate adjusted to 4 μg/(kg·h), maintained the treatment for 24 h, they were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, and the clinical indicators, the cardiac function, the adverse reactions in two groups before and after treatment were compared. Results After treatment, the clinical efficacy and in the control and treatment groups was 67.80% and 94.92%, respectively, and there were differences between two groups(P < 0.05). After treatment, the systolic blood pressure, diastolic blood pressure, and heart rate in two groups were significantly decreased(P < 0.05), and these clinical indicators in the treatment group were significantly lower than those in the control group(P < 0.05). After treatment, the cardiac function in two groups was significantly improved(P < 0.05), and the LVEDD and LVESD in the treatment group were significantly lower than those in the control group(P < 0.05), but the CI, LVEF, and CO in the treatment group were significantly higher than those in the control group(P < 0.05). During the treatment, the incidence of adverse reactions in the treatment group was significantly lower than that in the control group(P < 0.05). Conclusion Metoprolol combined with tirofiban has a significant therapeutic effect in treatment of acute myocardial infarction, which is beneficial to adjust and improve the left ventricular ejection fraction with high safety.