替罗非班联合美托洛尔治疗心肌梗死合并心律失常的疗效观察

Clinical Observation of Tirofiban Combined with Metoprolol in the Treatment of Myocardial Infarction with Arrhythmia

目的观察替罗非班联合美托洛尔治疗心肌梗死合并心律失常的临床疗效。方法纳入2021年5月至2022年12月医院96例心肌梗死合并心律失常患者进行前瞻性研究,将96例患者分为观察组与对照组,各48例。对照组接受控制血糖、溶栓、抗感染、扩张动脉等常规治疗,并在此基础上加用美托洛尔,观察组在对照组基础上加用替罗非班,两组均连续用药7d。于治疗7d时,评估两组患者临床疗效;比较两组治疗前、治疗7d时心肌损伤标志物[肌酸激酶(CK)、肌钙蛋白T(cTnT)、脑钠肽(BNP)、超敏C反应蛋白(hs-CRP)]、心功能[左房内径(LAD)、心脏指数(CI)、心输血量(CO)、左心室射血分数(LVEF)];记录两组治疗7d内不良反应发生情况。结果观察组治疗总有效率高于对照组(P<0.05)。治疗后,两组LAD水平较治疗前显著降低,且观察组低于对照组,LVEF、CI、CO水平均较治疗前升高,且观察组高于对照组(P<0.05)。治疗7d时,两组cTnT、CK、hs-CRP、BNP水平均较治疗前显著降低,且观察组低于对照组(P<0.05)。两组治疗期间不良反应发生率对比(P>0.05)。结论替罗非班与美托洛尔联合应用,可帮助降低心肌梗死合并心律失常患者的心肌损伤程度,并可帮助他们改善心功能,具有安全性。

Objective To observe the clinical efficacy of tirofiban combined with metoprolol in the treatment of myocardial infarction with arrhythmia.Methods A prospective study was conducted on 96 patients with myocardial infarction and arrhythmia in a hospital from May 2021 to December 2022.The 96 patients were divided into observation group and control group,with 48 cases in each group.The control group received routine treatment such as blood glucose control,thrombolysis,anti-infection,and artery dilatation,and metoprolol was added on this basis.The observation group received tirofiban on the basis of the control group.Both groups were treated continuously for 7 days.At the 7th day of treatment,the clinical efficacy of both groups of patients was evaluated.The myocardial injury markers[CK,cTnT,BNP,hs-CRP],cardiac function[left atrial diameter(LAD),cardiac index(CI),cardiac blood transfusion(CO),left ventricular ejection fraction(LVEF)]were compared in both groups before treatment and 7 days after treatment.The occurrence of adverse reactions in both groups within 7 days of treatment was recorded.Results Total effective rate of treatment in observation group was higher than control group(P<0.05).The LAD levels of both groups after treatment were significantly lower than before treatment,and compared with control group,observation group was lower.Compared with before treatment,LVEF,CI and CO levels were higher,and observation group was higher than control group(P<0.05).At the 7th day of treatment,levels of cTnT,CK,hs-CRP,and BNP in both groups were significantly lower than before treatment,observation group was lower than control group(P<0.05).There was no statistical significant difference in incidence of adverse reactions in the two groups during treatment(P>0.05).Conclusion Tirofiban combined with metoprolol is effective in the treatment of myocardial infarction with arrhythmia,can improve cardiac function,reduce myocardial injury,and is safe.