摘要
目的:观察替罗非班冠状动脉内注射治疗急性ST段抬高型心肌梗死(STEMI)患者的效果。方法:选取2021年10月至2023年10月该院收治的76例STEMI患者进行前瞻性研究,按照随机数字表法将其分为对照组和研究组各38例。对照组给予经皮冠状动脉介入治疗(PCI),研究组在对照组基础上联合冠状动脉内注射替罗非班治疗。比较两组治疗前后TIMI血流分级、心功能指标[左心室射血分数(LVEF)、心排血量(CO)、左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)]水平、心肌损伤标志物[脑钠肽(BNP)、可溶性细胞间黏附分子-1(sICAM-1)、肌酸激酶同工酶(CK-MB)]水平,以及主要不良心血管事件(MACE)发生率。结果:术后即刻,两组TIMI血流分级优于术前,且研究组优于对照组,差异有统计学意义(P<0.05);术后1周,两组LVEF、CO水平均高于术前,且研究组高于对照组,两组LVESD、LVEDD水平均低于术前,且研究组低于对照组,差异有统计学意义(P<0.05);两组BNP、sICAM-1、CK-MB水平均低于术前,且研究组低于对照组,差异有统计学意义(P<0.05);两组MACE发生率比较,差异无统计学意义(P>0.05)。结论:替罗非班冠状动脉内注射治疗STEMI患者,可改善TIMI血流分级,提高心功能,减轻心肌损伤,效果优于单纯PCI治疗。
Objective:To observe effects of Tirofiban intracoronary injection in treatment of patients with acute ST-segment elevation myocardial infarction(STEMI).Methods:A prospective study was conducted on 76 patients with STEMI admitted to the hospital from October 2021 to October 2023.According to the random number table method,they were divided into control group and study group,38 cases in each group.The control group was treated with percutaneous coronary intervention(PCI),while the study group was treated with intracoronary injection of Tirofiban on the basis of that of the control group.The TIMI blood flow classification,the levels of cardiac function indexes[left ventricular ejection fraction(LVEF),cardiac output(CO),left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD)]and myocardial injury markers[brain natriuretic peptide(BNP),soluble intercellular adhesion molecule-1(sICAM-1),creatine kinase isoenzyme(CK-MB)]before and after the treatment,and the incidence of major adverse cardiovascular events(MACE)were compared between the two groups.Results:Immediately after the surgery,the TIMI blood flow classification of the two groups was better than those before the surgery,that of the study group was better than that of the control group,and the differences were statistically significant(P<0.05).1 week after the surgery,the levels of LVEF and CO in the two groups were higher than those before the surgery,and those in the study group were higher than those in the control group;the levels of LVESD and LVEDD in the two groups were lower than those before the surgery,and those in the study group were lower than those in the control group;and the differences were statistically significant(P<0.05).The levels of BNP,sICAM-1 and CK-MB in the two groups were lower than those before the surgery,those in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of MACE between the two groups(P>0.05).Conclusions:Intracoronary injection of Tirofiban in the treatment of the STEMI patients can improve the TIMI blood flow classification,improve the cardiac function,and reduce the myocardial injury.Moreover,it is superior to simple PCI.
作者
汤慧民
TANG Huimin(2^(nd)Department of Cardiology of Ping Coal Shenma Medical Group General Hospital,Pingdingshan 467002 Henan,China)
出处
《中国民康医学》
2025年第20期22-24,28,共4页
Medical Journal of Chinese People’s Health
关键词
冠状动脉内注射
替罗非班
ST段抬高型心肌梗死
心功能
心肌损伤
Intracoronary injection
Tirofiban
ST-segment elevation myocardial infarction
Cardiac function
Myocardial injury
