血栓抽吸联合替罗非班注入治疗对急性心肌梗死患者经皮冠状动脉介入治疗后心肌损伤程度的影响

Effects of Thrombus Aspiration Combined with Tirofiban Injection on the Degree of Myocardial Injury in Acute Myocardial Infarction Patients after Percutaneous Coronary Intervention

目的探讨血栓抽吸联合替罗非班注入治疗对急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)术后心肌损伤程度的影响。方法选取2016年9月至2020年7月于深圳市蛇口人民医院进行PCI的176例AMI患者作为研究对象,按治疗方法不同分为对照组(n=102、接受常规PCI)、观察组(n=74、接受血栓抽吸联合替罗非班注入+PCI)。比较两组血清传统心肌酶谱指标、肌钙蛋白、甲状腺激素以及凋亡分子水平。结果 PCI术后24 h(T_(1)),观察组血清传统心肌酶谱指标肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、谷草转氨酶(GOT)、丙氨酸转氨酶(ALT)水平低于对照组(P<0.05);血清肌钙蛋白I(cTnI)、肌钙蛋白T(cTnT)水平低于对照组(P<0.05);血清甲状腺激素促甲状腺激素(TSH)、三碘甲状腺原氨酸(T_(3))、游离三碘甲状腺原氨酸(FT_(3))水平高于对照组(P<0.05);血清凋亡分子可溶性Fas(sFas)、可溶性FasL(sFasL)水平低于对照组(P<0.05)。结论 AMI患者行PCI过程中采用栓抽吸联合替罗非班注入治疗,可进一步减轻心肌损伤程度,对优化治疗结局具有重要意义。

Objective To investigate the effects of thrombus aspiration combined with tirofiban injection on the degree myocardial injury in patients with acute myocardial infarction(AMI) after percutaneous coronary intervention(PCI).Methods A total of 176 AMI patients underwent PCI treatment in Shenzhen Shekou People’s Hospital from September 2016 to July 2020 were chosen as research subject,and according to different treatment methods,all patients were divided into a control group(n=102,underwent conventional PCI treatment),and a study group(n=74,underwent thrombus aspiration combined with tirofiban injection + PCI treatment).Serum contents of traditional myocardial enzymes,troponin,thyroid hormones and levels of apoptotic molecules were compared between 2 groups.Results 24 h after PCI(T_(1)),serum contents of CK-MB,LDH,GOT and ALT in study group were lower than those in control group(P<0.05);serum contents of cTnI and cTnT in study group were lower than those in control group(P<0.05);serum contents of TSH,T_(3)and FT_(3)in study group were higher than those in control group(P<0.05);serum levels of apoptotic molecules sFas and sFasL in study group were lower than those in control group(P < 0.05).Conclusion Thrombosuction combines with tirofiban injection can further reduce the degree of myocardial injury in patients with AMI after PCI,which has great significance to optimize the outcome of treatment.