冠状动脉内注射替罗非班在急性ST段抬高型心肌梗死(STEMI)冠状动脉介入手术治疗(PCI)中对血流动力学的影响

Effects of Intra-coronary Injection of Tirofiban on Hemodynamics in Coronary Interventional Surgery(PCI)for Acute ST-segment Elevation Myocardial Infarction(STEMI)

目的 研究急性ST段抬高型心肌梗死(STEMI)患者行冠状动脉介入术(PCI)+替罗非班治疗对血流动力学的影响。方法 研究时段为2018年1月至2019年4月,研究对象为我院收治的80例STEMI患者,采纳“就诊先后顺序”随机划分成两组,即观察组(PCI术+替罗非班)与对照组(单纯行PCI术)各40例,两组心功能、TIMI血流分级及ST段回落情况比较。结果术前比较两组临床指标无差异,P>0.05;术后与对照组比较,观察组LEVDD、LVESD及BNP指标更低,LVEF指标更高;观察组3级血流分级比例(95.00%)高于对照组(80.00%);观察组回落率(87.50%)高于对照组(67.50%);观察组不良事件发生率(5.00%)低于对照组(20.00%),χ^(2)=4.1143、4.5878、4.1143;P=0.0425、0.0322、0.0425,P<0.05。结论 PCI术+替罗非班治疗STEMI患者能改善血流动力学指标,提高整体疗效、增加对缺血区的心肌再灌注,提高冠状动脉血流、改善预后效果,促进心功能尽早恢复,达到远期疗效目的,严格控制疾病进展,安全可靠、具有较高的临床应用价值。

Objective To study the effect of coronary intervention(PCI)+tirofiban on hemodynamics in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods During the study from January 2018 to April 2019,the study subjects 80 STEMI patients admitted to our hospital were randomly divided into two groups based on the sequence of visits,namely:observation group(PCI+tirofiban)and control group(simple line PCI)40 cases in each group,comparison of cardiac function,TIMI blood flow classification and ST-segment fall between the two groups.Results There was no difference in clinical indicators between the two groups before operation,P>0.05;after the operation,compared with the control group,the LEVDD,LVESD and BNP indicators of the observation group were lower,and the LVEF indicators were higher;the observation group had a higher blood flow classification ratio(95.00%)Is higher than the control group(80.00%);the observation group's fall rate(87.50%)is higher than the control group's(67.50%);the observation group's adverse event rate(5.00%)is lower than the control group(20.00%),χ^(2)=4.1143,4.5878,4.1143;P=0.0425,0.0322,0.0425,P<0.05(statistical significance).Conclusion PCI plus tirofiban in the treatment of STEMI patients can improve hemodynamic indicators,improve overall efficacy,increase myocardial reperfusion in ischemic areas,increase coronary blood flow,improve prognosis,and promote the heart function recover as soon as possible to achieve the purpose of long-term curative effect,strictly control disease progression,safe and reliable,and has high clinical application value,which is worthy of praise.