替罗非班联合双抗对AMI患者PCI术后康复效果及MACE的影响

Effect of Tirofiban Combined with Double Antibody on Postoperative Rehabilitation and Mace in Patients with AMI after PCI

目的:探究替罗非班联合双抗对急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)术后康复效果及主要不良心血管事件(MACE)的影响。方法:选取2022年1月—2024年1月漳州市第三医院收治的80例AMI患者作为研究对象,随机将其分为对照组和观察组,对照组(n=40)采用阿司匹林+替格瑞洛双抗进行治疗,观察组(n=40)在对照组基础上加以替罗非班治疗。比较两组治疗后疗效,比较治疗前后两组冠脉微循环[开始灌注时间(AT)、曲线上升斜率(β)、灌注峰值强度(PI)、振幅(A)]、患者心肌梗死溶栓疗法(TIMI)危险评分、心功能[左室射血分数(LVEF)、左室收缩末期容积指数(LVESVI)、左室舒张末期容积指数(LVEDVI)]变化水平,统计治疗过程中两组MACE发生情况。结果:治疗后,两组TIMI分级在0级、Ⅰ级比较,差异无统计学意义(P>0.05);治疗后,观察组TIMI分级在Ⅱ级、Ⅲ级例数均少于对照组,差异有统计学意义(P<0.05);观察组治疗有效率高于对照组,差异有统计学意义(P<0.05);治疗后,AT、PI、A、β、LVEF均高于对照组;观察组LVESVI、LVEDVI低于对照组,差异有统计学意义(P<0.05);治疗过程中观察组MACE发生情况低于对照组,差异有统计学意义(P<0.05)。结论:对于AMI行PCI患者,替罗非班与阿司匹林、替格瑞洛的联合治疗方案有效改善冠脉微循环和心功能,促进心肌再灌注,提高预后效果。

Objective:To explore the effects of Tirofiban combined with double antibody on postoperative rehabilitation and Major Adverse Cardiovascular Events(MACE)in patients with Acute Myocardial Infarction(AMI)after Percutaneous Coronary Intervention(PCI).Method:A total of 80 patients with AMI who underwent PCI in Zhangzhou Third Hospital from January 2022 to January 2024 were selected as the study objects and randomly divided into two groups.The control group(n=40)was treated with aspirin and ticagrelor,while the observation group(n=40)was treated with tirofiban on the basis of the control group.After comparing the curative effect of the two groups,Coronary microcirculation[time to start perfusion(AT),slope of curve rise(β),peak perfusion intensity(PI),amplitude(A)],Thrombolysis In Myocardial Infarction(TIMI)risk score,cardiac function[left ventricular ejection fraction(LVEF),left ventricular end-systolic volume index(LVESVI),and left ventricular end-diastolic volume index were compared between the two groups before and after treatment.And major adverse cardiovascular events(MACE)of the two groups were measured during treatment.Result:After treatment,there was no significant difference between the two groups in grade 0 and GradeⅠTIMI classification(P>0.05).After treatment,the number of cases of gradeⅡand gradeⅢTIMI classification in the observation group was less than that in the control group,and the difference was statistically significant(P<0.05).The effective rate of treatment in the observation group was higher than that in the control group(P<0.05).After treatment AT,PI,A,βand LVEF were higher than that in the control group.LVESVI and LVEDVI in the observation group were significantly lower than those in the control group(P<0.05).And the occurrence of MACE in the observation group was significantly lower than that in the control group during treatment(P<0.05).Conclusion:For patients with AMI after PCI,the combination regimen of Tirofiban,aspirin and ticagrelor can effectively improve coronary microcirculation and cardiac function,promote myocardial reperfusion and improve prognosis.