PCI联合替罗非班治疗急性心肌梗死及对心功能、sP-sel、Cys C的影响

The effect of PCI combined with tirofiban in the treatment of acute myocardial infarction on cardiac function,sP-sel and Cys C

目的探究与分析经皮冠状动脉介入治疗(PCI)联合替罗非班治疗急性心肌梗死及对心功能、可溶性P选择素(sP-sel)、胱抑素C(Cys C)的影响。方法选取自2019年4月~2021年2月收治的急性心肌梗死患者120例,采取随机数表法分为半剂量组与全剂量组,每组60例。两组均给予PCI术治疗,在PCI手术治疗期间注射10μg/kg的替罗非班治疗,术后半剂量组给予0.075μg/(kg·min)静脉泵注替罗非班治疗,全剂量组给予0.15μg/(kg·min)静脉泵注替罗非班治疗,对比两组患者临床疗效、治疗前后心功能指标、心肌灌注分级、sP-sel、Cys C变化。结果与半剂量组相比,全剂量组临床总有效率较高,差异有统计学意义(P<0.05)。与半剂量组治疗后相比,全剂量组治疗后LVEF较高、LVEDd较低、LVESd较低,差异有统计学意义(P<0.05)。全剂量组治疗后与半剂量组治疗后相比心肌灌注分级较高,差异有统计学意义(P<0.05)。全剂量组治疗后与半剂量组治疗后相比sP-sel较低、Cys C较低,差异有统计学意义(P<0.05)。结论PCI术后联合不同剂量替罗非班治疗急性心肌梗死均可取得一定的效果,其中与半剂量的替罗非班相比,全剂量可更好地改善心肌功能及心肌灌注分级,同时还可调节sP-sel、Cys C水平。

Objective To explore and analyze the effects of percutaneous coronary intervention(PCI)combined with tirofiban in the treatment of acute myocardial infarction on cardiac function and soluble P-sel and Cys C.Methods A selection of 120 patients with acute myocardial infarction admitted to our hospital from April 2019 to February 2021 were divided into half-dose group and full-dose group by random number table,60 cases in each group,and both groups were given PCI treatment.During PCI surgery,10μg/kg of tirofiban was injected,then the half-dose group was given intravenous tirofiban with a pump injection at a rate of 0.075μg/(kg·min),and the full-dose group was given a pump injection of tirofibanat a rate of 0.15μg/(kg·min).The clinical efficacy,cardiac function indexes,myocardial perfusion grade,sP-sel and Cys C changes before and after treatment were compared between the two groups.Results Compared with the half-dose group,the full-dose group had a higher clinical total effective rate,and the difference was statistically significant(P<0.05).Compared with the half-dose group after treatment,the full-dose group had higher LVEF,lower LVEDd,and lower LVESd,and the differences were statistically significant(P<0.05).The myocardial perfusion grade was higher in the full-dose group compared with the half-dose group after treatment,and the difference was statistically significant(P<0.05).Compared with the half-dose group after treatment,the sP-sel and Cys C were lower in the full-dose group and the difference was statistically significant(P<0.05).Conclusion PCI combined with different doses of tirofiban can achieve a certain effect in the treatment of acute myocardial infarction.Compared with half-dose tirofiban,the full dose can better improve myocardial function and myocardial perfusion grade,and it can also adjust sP-sel,Cys C levels.