替罗非班联合综合用药方案对冠心病患者PCI术后疗效的影响

Effect of Tirofiban Combined with Comprehensive Medication Regimen on the Efficacy of Patients with Coronary Heart Disease after PCI

目的 研究替罗非班+综合用药方案运用于冠心病经皮冠状动脉介入术(PCI)中的价值。方法 选择新郑华信民生医院2019年8月至2020年11月接收的冠心病患者60例,均给予PCI治疗,通过随机列表法进行分组,其中30例术后注射肝素治疗的患者收入对照组,其余30例术后注射替罗非班的患者收入研究组,两组围术期均给予综合用药方案,观察两组患者心功能和炎性因子水平变化,比较药物治疗的不良反应发生率。结果 治疗前各组射血分数(LVEF)、左心室舒张末期和收缩末期容量(LVEDV和LVESV)比较,差异无统计学意义(P>0.05);治疗后,两组LVEF水平均高于本组治疗前,LVEDV和LVESV水平均低于本组治疗前,差异有统计学意义(P<0.05);且研究组治疗后LVEF水平均高于对照组,LVEDV和LVESV水平均低于对照组,差异有统计学意义(P<0.05)。两组治疗前白介素-8(IL-8)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)水平比较,差异无统计学意义(P>0.05);治疗后,两组IL-8、TNF-α和hs-CRP水平均低于本组治疗前,差异有统计学意义(P<0.05);且研究组治疗后IL-8、TNF-α和hs-CRP水平均低于对照组,差异有统计学意义(P<0.05)。研究组不良反应发生率(6.67%)低于对照组(26.67%),差异有统计学意义(P<0.05)。结论 替罗非班联合综合用药方案不仅可以有效改善冠心病PCI患者术后的心功能,还可以在降低hs-CRP等炎性因子水平,减少炎症介质的释放的同时,减少药物治疗不良反应,临床治疗效果显著。

Objective To discuss the influence of tirofiban and comprehensive medication schemes after percutaneous coronary intervention(PCI) for coronary heart disease. Methods Sixty patients with coronary heart disease admitted to Xinzheng Huaxin People’s Hospital from August 2019 to November 2020 were selected to receive PCI treatment and grouped by random list method. Among them, 30 patients receiving postoperative heparin injection were included in the control group, and the rest of 30patients receiving postoperative tirofiban injection were included in the research group. Both groups were given comprehensive medication regimen during perioperative period. The changes of cardiac function and inflammatory factors in the two groups were observed, and the incidence of adverse reactions was compared. Results Before treatment, there were no significant differences in ejection fraction(LVEF), left ventricular end-diastolic and end-systolic volumes(LVEDV and LVESV) among all groups(P>0.05). After treatment, LVEF levels in 2 groups were higher than before, LVEDV and LVESV levels were lower than before,the difference was statistically significant(P<0.05). After treatment, LVEF levels in the study group were higher than those in the control group, while LVEDV and LVESV levels were lower than those in the control group, with statistical significance(P<0.05). There was no significant difference in the levels of interleukin-8(IL-8), hypersensitive C-reactive protein(hs-CRP)and tumor necrosis factor-α(TNF-α) between the two groups before treatment(P>0.05). After treatment, the levels of IL-8,TNF-α and hs-CRP in 2 groups were lower than before treatment, the difference was statistically significant(P<0.05). The levels of IL-8, TNF-α and hs-CRP in the study group were lower than those in the control group after treatment, and the difference was statistically significant(P<0.05). The incidence of adverse reactions in the study group(6.67%) was lower than that in the control group(26.67%), and the difference was statistically significant(P<0.05). Conclusion Tirofiban combined with comprehensive medication regimen can not only effectively improve the cardiac function of patients with coronary heart disease after PCI, but also reduce the level of inflammatory factors such as hs-CRP and the release of inflammatory mediators at the same time, and reduce the adverse reaction of drug therapy. The clinical therapeutic effect is significant.