低分子肝素联合替罗非班治疗非Q波心肌梗死患者的临床疗效及安全性

Clinical effect and safety of low molecular weight heparin combined with tirofiban in the treatment of non-Q-wave myocardial infarction

目的观察低分子肝素(LMWH)联合替罗非班治疗非Q波心肌梗死(NQMI)患者的临床疗效及安全性。方法选取2019年6月—2021年1月泗洪县分金亭医院收治的NQMI患者146例作为研究对象,按照随机数字表法分为对照组和观察组,各73例。患者入院后均接受常规治疗,其中对照组予以低分子肝素钙持续治疗1周,观察组在对照组基础上予以替罗非班持续治疗5 d。比较2组临床疗效及治疗前后心功能指标[左心室舒张末期内径(LVDED)、左心房内径(LAD)、左心室射血分数(LVEF)]、心肌酶指标[肌酸激酶同工酶(CK-MB)、肌酸激酶(CK)],不良反应。结果观察组总有效率为93.15%,高于对照组的82.19%(χ^(2)=4.056,P=0.044)。治疗后,2组LVDED、LAD小于治疗前,LVEF高于治疗前,且观察组LAD、LVDED小于对照组,LVEF高于对照组(P<0.01)。治疗后,2组CK-MB、CK水平低于治疗前,且观察组低于对照组(P<0.01)。观察组不良反应总发生率为2.74%,低于对照组的10.96%(χ^(2)=3.865,P=0.049)。结论LMWH联合替罗非班治疗NQMI患者的临床疗效确切,可有效改善患者的心功能,减轻心肌损伤,且安全性较高。

Objective To investigate the clinical effect and safety of low molecular weight heparin(LMWH)combined with tirofiban in the treatment of non-Q-wave myocardial infarction(NQMI).Methods A total of 146 patients with NQMI treated in Fenjinting Hospital,Sihong County from June 2019 to January 2021 were selected,and they were divided into control group and observation group according to random number table method,73 cases in each group.All patients were given conventional therapy,and patients in control group were continuously treated with low molecular weight heparin calcium for 1 week,patients in observation group were treated with tirofiban for 5 days on the basis of control group.Curative effect,cardiac function indexes(LVDED,LAD,LVEF),myocardial enzyme indexes(CK-MB,CK)before and after treatment,incidence of adverse reactions were compared between the two groups.Results Total effective rate in observation group was 93.15%,which was higher than 82.19%of control group(χ^(2)=4.056,P=0.044).After treatment,LVDED,LAD in the two groups were less than those before treatment,LVEF was higher than that before treatment,and LAD,LVDED in observation group were less than those in control group,LVEF was higher than that in control group(P<0.01).After treatment,CK-MB,CK levels in the two groups were lower than those before treatment,and those in observation group were lower than control group(P<0.01).Incidence of adverse reactions in observation group was 2.74%,which was lower than 10.96%in control group(χ^(2)=3.865,P=0.049).Conclusion LMWH combined with tirofiban have an exact clinical effect in the treatment of NQMI patients,can effectively improve cardiac function of patients,reduce myocardial damage,and with high safety.