替罗非班对急性ST段抬高型心肌梗死PCI术后再灌注指标及心功能的影响

Effect of Tirofiban on Reperfusion Indices and Cardiac Function in Post-PCI STEMI Patients

目的 :观察替罗非班对急性ST段抬高型心肌梗死(STEMI)经皮冠状动脉介入治疗(PCI)术后再灌注指标及心功能的影响。方法:选取我院介入手术室2015年5月-2017年5月收治的STEMI患者50例,按随机数字表法分为观察组及对照组,各25例。对照组实施单纯的PCI治疗。观察组在对照组基础上联合使用替罗非班,静脉推注10μg/(kg·min)为负荷量,持续剂量为0.151μg/(kg·min),术后持续泵入48 h。术中经导管内注射10μg/kg替罗非班,注射时间为5 min。比较两组术后再灌注指标及心功能。结果 :治疗2 h后,观察组心肌梗死溶栓治疗(TIMI)3级血流占比、ST段回落幅度≥50%占比高于对照组(P<0.05),CK-MB峰值及峰值时间均低于对照组,心功能指标水平均优于对照组,且不良心血管事件发生率低于对照组,差异均有统计学意义(P<0.05)。结论:替罗非班联合PCI治疗STEMI能够促进患者梗死冠脉再次恢复灌注,改善心功能,降低不良心血管事件发生风险,安全可靠,疗效确切。

Objective:To examine the effect of tirofiban on reperfusion indices and cardiac function of acute ST segment elevation myocardial infarction(STEMI) patients after percutaneous coronary intervention(PCI). Methods:Fifty STEMI patients admitted to the interventional operating room of Shangqiu First People's Hospital between May 2015 to May 2017 were randomly divided into the observation group(n=25) and control group(n=25). Control group patients were treated with PCI alone, and observation group patients were treated with PCI combined with tirofiban. Tirofiban was intravenously administered at a loading dose of 10 μg/(kg·min) and a continuous dose of 0.151 μg/(kg·min) for up to 48 h post-PCI. Tirofiban was injected through a catheter during PCI at 10 μg/kg for 5 min. Postoperative reperfusion indices and cardiac function were compared between the two groups. Results:At 2 h posttreatment, the proportions of TIMI grade 3 blood flow and ST segment recovery ≥50% were significantly higher in the observation group than in the control group(P<0.05). In addition, the observation group has significantly lower CK-MB peak value and peak time, higher cardiac function and lower incidence of adverse cardiac events(all P<0.05) than the control group. Conclusion:Tirofiban combined with PCI is a safe, reliable and efficacious treatment that promotes infarcted artery reperfusion, improves cardiac function and reduces adverse cardiac events in STEMI patients.