血栓抽吸导管联合替罗非班及硝普钠在急性ST段抬高型心肌梗死经皮冠状动脉介入术中的疗效

Efficacy of Thrombus Aspiration Catheter Combined with Tirofiban and Sodium Nitroprusside in Percutaneous Coronary Intervention for Acute ST-Segment Elevation Myocardial Infarction

目的:探讨急性ST段抬高型心肌梗死经皮冠状动脉介入治疗(PCI)中给予血栓抽吸导管联合替罗非班及硝普钠的应用效果。方法:选取2020年4月-2022年3月台山市人民医院心血管二科收治的急性ST段抬高型心肌梗死患者90例为观察对象,根据治疗方式不同分为研究1组、研究2组、研究3组,各30例。研究1组给予血栓抽吸、替罗非班、硝普钠与PCI,研究2组给予血栓抽吸、替罗非班与PCI;研究3组给予PCI治疗,比较三组患者心肌梗死溶栓治疗危险评分(TIMI)血流分级、临床疗效及N端脑钠肽前体(NT-proBNP)、C反应蛋白(CRP)指标变化情况。结果:研究1组TIMI血流分级3级比例高于研究2组、研究3组,差异有统计学意义(P<0.05);研究1组总有效率高于研究2组、研究3组,差异有统计学意义(P<0.05);治疗后,研究1组NT-proBNP、CRP指标水平低于研究2组和研究3组,差异有统计学意义(P<0.05)。结论:急性ST段抬高型心肌梗死急诊PCI中,开展血栓抽吸导管联合替罗非班及硝普钠治疗,可明显改善TIMI血流分级情况,改善NT-proBNP、CRP指标水平。

Objective:To investigate the efficacy of thrombus aspiration catheter combined with tirofiban and sodium nitroprusside in percutaneous coronary intervention(PCI)for acute ST-segment elevation myocardial infarction.Methods:90 patients with acute ST-segment elevation myocardial infarction admitted to the Department of Cardiovascular II of Taishan People's Hospital from April 2020 to March 2022 were selected as observation subjects and divided into study groups 1,2 and 3 according to the treatment modality,with 30 cases in each group.Thrombus aspiration,tirofiban,sodium nitroprusside and PCI were given to study group 1,and thrombus aspiration,tirofiban and PCI were given to study group 2;PCI was given to study group 3,and the changes of Thrombolysis in Myocardial Infarction risk score(TIMI)blood flow classification,clinical efficacy and Nterminal brain natriuretic peptide precursor(NT-proBNP)and C-reactive protein(CRP)indexes in the three groups were compared.Results:The proportion of TIMI blood flow grade 3 in study group 1 was higher than that in study group 2 and study group 3,and the difference was statistically significant(P<0.05).The total effective rate in study group 1 was higher than that in study group 2 and study group 3,and the difference was statistically significant(P<0.05).After treatment,the levels of NTproBNP and CRP indexes in study group 1 were lower than those in study group 2 and study group 3,and the difference was statistically significant(P<0.05).Conclusion:Thrombus aspiration catheter combined with tirofiban and sodium nitroprusside in acute ST-segment elevation myocardial infarction emergency PCI can significantly improve TIMI flow classification and improve NT-proBNP and CRP index levels.