盐酸替罗非班治疗急性心肌梗死的临床疗效观察及相应机制  

Clinical Observation on Curative Effect of Tirofiban Hydrochloride on Acute Myocardial Infarction and Corresponding Mechanism

作　　者：张吉红[1] 尹雪松[1] 宁文虎[1] 彭成海[1] 任仲侨[1] 高晗[1] 赵侃[1] 

机构地区：[1]哈尔滨医科大学附属第四医院,黑龙江哈尔滨150001

出　　处：《现代生物医学进展》2012年第32期6294-6297,共4页Progress in Modern Biomedicine

基　　金：2008年哈尔滨市科技攻关项目(2007AA3CS08-4)

摘　　要：目的:观察盐酸替罗非班对急性心肌梗死的临床疗效及相应机制。方法:哈尔滨医科大学附属第四医院急诊急救中心入选急性ST段抬高型心肌梗死的患者(n=50),其中男性35例,女性15例,平均年龄58.4±10.3岁,给予内科药物治疗。患者随机分为常规药物组(n=23)和替罗非班组(常规药物+替罗非班,n=27)。通过观察临床症状和心电图ST段变化评价治疗效果,应用血小板聚集仪比浊法测定样本不同时间点(治疗前,给药过程中,给药结束后2小时)血小板聚集率变化以及应用酶联免疫吸附剂测定(ELISA)方法检测血清中血小板第四因子(PF4)的水平变化。并进一步做相关性分析。结果:与常规药物组比较,替罗非班组患者胸痛明显减轻,心电图ST回落指数增加(P<0.05),给药过程中血小板聚集率明显降低(P<0.001),同时血清中PF4的水平也显著降低(P<0.001),并且与血小板聚集率呈正相关性(r=0.86,P<0.001)。结论:盐酸替罗非班对于急性ST段抬高型急性心肌梗死有确切的治疗效果,可能是通过抑制血小板的聚集和减少PF4的释放而发挥作用的。Objective： To observe the clinical efficacy and mechanism ofhydrochloricacid for tirofiban in acute myocardial infarction. Methods： The Fourth Affiliated Hospital of Harbin Medical Center emergency first aid selected patients with acute ST-segment elevation myocardial infarction （n = 50）, 35 males and 15 females, mean age of 58.4±10.3 years, for medical therapy. Assess the curative effect by observing the clinical symptoms and ECG ST-segment changes. The platelet aggregation analyzer turbidimetric method samples were applied to detect the platelet aggregation changes at different time points （before treatment, administration of the process, administered after 2 hours）, and enzyme-linked immunosorbent assay （ELISA） was used to detect serum platelet fourth factor （PF4） level changes. And further to do correlation analysis. Results： Compared with the conventional drug group, tirofiban significantly reduced the chest pain, in-creased ECG ST drop index （P 〈0.05）, decreased the platelet aggregation rate during the administration （P 〈0.001）. While serum levels of PF4 were also significantly lowered （P 〈0.001）, and positively correlated with platelet aggregation rate （r = 0.86, P 〈0.001）. Conclusion： Tirofiban hydrochloride had curative effect on acute ST-segment elevation myocardial infarction, probably by inhibiting platelet aggrega-tion and reducing the release of PF4.

关 键 词：急性ST段抬高型心肌梗死 替罗非班 血小板聚集率 PF4 

分 类 号：R542.22[医药卫生—心血管疾病]