替罗非班不同途径给药治疗冠心病急性心肌梗死的有效性及安全性比较

Compaison of efficacy and safety of different routes of administration of tirofiban in the treatment of coronary heart disease complicated with acute myocardial infarction

目的探讨替罗非班不同途径给药治疗冠心病急性心肌梗死的有效性及安全性。方法择取2019年1月至2022年2月收治的124例冠心病急性心肌梗死患者,根据给药方式将其分为对照组和观察组,各62例。对照组以静脉注射方式给药给予替罗非班治疗,观察组以冠状动脉注射方式给药给予替罗非班治疗。比较两组的治疗效果。结果治疗后,观察组的冠脉血流储备(CFVR)、舒张期血流峰值(DPV)、收缩期血流峰值(SPV)高于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组的乳酸脱氢酶(LDH)、肌酸激酶同工酶(CK-MB)、肌钙蛋白I(cTnI)、肌红蛋白(MYO)水平均低于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组的心肌梗死溶栓试验(TIMI)分级Ⅱ级占比显著低于对照组,Ⅲ级占比显著高于对照组,差异具有统计学意义(P<0.05)。观察组的不良事件总发生率低于对照组,差异具有统计学意义(P<0.05)。结论以冠状动脉注射方式给予替罗非班治疗冠心病急性心肌梗死,能进一步调节冠脉血流及心肌酶谱指标水平,改善TIMI分级,降低不良事件发生率。

Objective To investigate the efficacy and safety of different routes of administration of tirofiban in the treatment of coronary heart disease complicated with acute myocardial infarction.Methods A total of 124 patients with coronary heart disease complicated with acute myocardial infarction admitted from January 2019 to February 2022 were selected and divided into control group and observation group according to the mode of administration,with 62 cases in each group.The control group was treated with tirofiban by intravenous injection,and the observation group was treated with tirofiban by coronary artery injection.The therapeutic effects of the two groups were compared.Results After treatment,the coronary flow velocity reserve(CFVR),diastolic peak velocity(DPV)and systolic peak velocity(SPV)in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of lactate dehydrogenase(LDH),creatine kinase isoenzyme(CK-MB),cardiac troponin I(cTnI)and myoglobin(MYO)in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the proportion of thrombolysis in myocardial infarction(TIMI)gradeⅡin the observation group was significantly lower than that in the control group,the proportion of gradeⅢwas significantly higher than that in the control group,and the differences were statistically significant(P<0.05).The total incidence of adverse events in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Tirofiban administrated by coronary artery injection in the treatment of coronary heart disease complicated with acute myocardial infarction can further regulate the coronary blood flow and levels of myocardial enzymes,improve TIMI classification and reduce the incidence of adverse events.