替罗非班对急诊经皮动脉介入术(PCI)患者的临床疗效

Clinical efficacy analysis on use of tirofiban in emergency PCI patients

目的探讨替罗非班对急性经皮动脉介入术(PCI)患者的临床疗效。方法选取急性心肌梗死患者240例,分成对照组与观察组各120例。2组患者入院当天进行常规体检,控制血糖、血脂、高血压,入院即口服替格瑞洛180 mg和阿司匹林300 mg,行心电监测及多次心电图检查。对照组患者均接受单纯急诊PCI治疗及常规药物治疗,观察组患者在对照组手术和常规药物治疗基础上注射替罗非班治疗。比较2组患者心肌生化标志物(肌钙蛋白、肌酸激酶)及氨基末端B型脑钠肽(NT-proBNP)水平、心功能、炎症因子(TNF-α、hsCRP)、不良事件。结果治疗前2组患者的心肌生化标志物及NT-proBNP水平比较差异无统计学意义(P>0.05),治疗后2组患者心肌生化标志物及NT-proBNP水平较治疗前升高,其中观察组患者的肌钙蛋白、肌酸激酶、NT-proBNP水平低于对照组(P<0.05)。术后48 h 2组患者LVESV、LVEDV、LVEF比较差异无统计学意义(P>0.05),治疗后90 d对照组患者LVESV、LVEDV、LVEF较术后48 h高,观察组患者LVESV、LVEDV较术后48 h低,LVEF较术后48 h高;观察组患者治疗90 d的LVESV、LVEDV水平低于对照组(P<0.05),LVEF高于对照组(P<0.05)。治疗前2组患者炎症因子水平比较差异无统计学意义(P>0.05),治疗后2组患者TNF-α、hsCRP水平降低,其中观察组患者治疗后的TNF-α、hsCRP水平显著低于对照组(P<0.05)。结论替罗非班能作为急诊PCI治疗急性心肌梗死临床辅助药物,可保护心肌功能,减少细胞损伤,值得推荐使用。

Objective To explore the clinical efficacy of tirofiban in emergency PCI patients.Methods A total of 1 325 patients with acute myocardial infarction admitted were selected,and 240 patients were included in the study after exclusion.240 patients were randomly divided into a control group and an observation group(n=120).On the day of admission,both groups received routine physical examination and controlled blood sugar,blood lipids and high blood pressure.On admission,oral ticagrelor 180 mg and aspirin 300 mg were administered,and ECG monitoring and multiple electrocardiograms were performed.Patients in the control group received emergency PCI alone,and patients in the observation group were treated with tirofiban on the basis of the control group.Patients in the control group received emergency PCI and conventional drug therapy.The patients in the observation group were treated with tirofiban on the basis of surgery and conventional drug therapy.Myocardial biochemical markers(troponin,creatine kinase)and amino terminal B-type brain natriuretic peptide levels,cardiac function,inflammatory factors(TNF-α,hsCRP),adverse events of patients between two groups were compared.Results There were no significant differences in myocardial biochemical markers and NT-proBNP levels of patients between the two groups before treatment(P>0.05).The difference of myocardial biochemical markers and NT-proBNP levels between the two groups was higher than that before treatment.The levels of troponin,creatine kinase and NT-proBNP in the observation group were lower than those in the control group(P<0.05).There were no significant differences in LVESV,LVEDV and LVEF between the two groups before treatment(P>0.05).After treatment,the LVESV,LVEDV and LVEF were higher in the control group than in the pre-treatment group.The LVESV and LVEDV in the observation group were lower than those before treatment,and the LVEF was lower.The levels of LVESV and LVEDV in the observation group were lower than those in the control group(P<0.05),and LVEF was higher than that in the control group(P<0.05).There was no significant difference in the levels of inflammatory factors between the two groups before treatment(P>0.05).After treatment,the levels of TNF-αand hsCRP were decreased in the two groups.The TNF-αand hsCRP levels in the observation group were significantly lower than those in the control group(P<0.05).The incidence of adverse events was lower in the observation group than in the control group(P<0.05).Conclusion Tirofiban can be used as an ancillary drug for the treatment of acute myocardial infarction in acute PCI,which can reduce adverse surgical events,protect myocardial function and reduce cell damage.It is recommended for use.