冠状动脉球囊扩张术中注射替罗非班对急性心肌梗死患者内皮功能及早期心功能的影响  

Influence by injection of tirofiban during coronary artery balloon dilatation on endothelial function and early cardiac function in acute myocardial infarction patients

作　　者：林秋伟[1] 朱秀龙[1] 张灿[1] 陈炎[1] 

机构地区：[1]广东省高州市高州市人民医院心内科,525200

出　　处：《中国实用医药》2017年第12期21-24,共4页China Practical Medicine

基　　金：2016年度茂名市科技计划立项项目(项目编号:2016214)

摘　　要：目的探究冠状动脉球囊扩张术中注射替罗非班对急性心肌梗死患者内皮功能及早期心功能的影响。方法 80例急性心肌梗死患者,随机分为观察组(冠状动脉球囊扩张术中给予替罗非班注射治疗)及对照组(常规进行冠状动脉球囊扩张术治疗),各40例,对比两组临床治疗总有效率、TIMI血流分级、内皮功能及早期心功能。结果治疗后观察组总有效率为97.5%,显著高于对照组的85.0%,差异具有统计学意义(P<0.05)。观察组TIMI血流分级情况明显优于对照组,差异具有统计学意义(P<0.05)。术前两组各内皮功能指标对比,差异无统计学意义(P>0.05)。术后对照组可溶性细胞黏附因子1(s ICAM-1)为(34.6±4.7)μg/L、可溶性血管细胞黏附分子1(s VCAM-1)为(40.6±4.0)μg/L、血管性血友病因子(v WF)为(723.5±123.4)U/L、炎症反应标志物超敏C反应蛋白(hs-CRP)为(7.4±2.1)mg/L均显著高于观察组的(23.5±4.1)μg/L、(24.3±2.3)μg/L、(534.2±112.3)U/L、(6.2±2.0)mg/L,差异具有统计学意义(P<0.05)。术前两组各心功能指标对比差异无统计学意义(P>0.05)。观察组术后左心室舒张末期内径(LVEDD)为(50.2±4.9)mm,左心室射血分数(LVEF)为(52.3±5.4)%显著优于对照组的(54.8±3.6)mm、(48.7±3.9)%,差异具有统计学意义(P<0.05)。结论急性心肌梗死患者冠状动脉球囊扩张术中采用替罗非班注射治疗,可显著改善患者内皮功能与早期心功能,效果显著。Objective To investigate influence by injection of tirofiban during coronary artery balloon dilatation on endothelial function and early cardiac function in acute myocardial infarction patients. Methods A total of 80 patients with acute myocardial infarction were randomly divided into observation group （received injection of tirofiban during coronary artery balloon dilatation） and control group （received conventional coronary artery balloon dilatation）, with 40 cases in each group. Comparison was made on total effective rate in clinical treatment, TIMI blood flow grade, eridotheliat function and early cardiac function between the two groups. Results After treatment, the observation group had obviously higher total effective rate as 97.5% than 85.0% in the control group, and their difference had statistical significance （P〈0.05）. The observation group had much better TIMI blood flow grade than the control group, and their difference had statistical significance （P〈0.05）. There was no statistically significant difference of endothelial function indexes between the two groups before operation （P〉0.05）. After operation, the control group had soluble intercellular adhesion molecule 1 （sICAM-1） as （34.6 ±4.7）μg/L, soluble vascular cell adhesion molecule 1 as （sVCAM-1） as （40.6 ± 4.0） μg/L, van Willebrand factor （vWF） as （723.5 ±123.4） U/L, and high-sensitivity C-reactive protein （hs-CRP） as inflammatory marker as （7.4 ± 2.1） mg/L, which were all higher than （23.5 ±4.1） μg/L, （24.3 ± 2.3）μg/L, （534.2 ± 112.3） U/L and （6.2 ± 2.0） mg/L in the observation group. Their difference had statistical significance （P〉0.05）. The difference of cardiac function indexes before operation had no statistical significance between the two groups （P〉0.05）. The observation group had much better left ventricular end diastolic dimension （LVEDD） as （50.2± 4.9） mm than （54.8 ± 3.6） mm in the control group, and ithad higher left ventri

关 键 词：冠状动脉 替罗非班 急性心肌梗死 内皮功能 早期心功能 球囊扩张术 

分 类 号：R542.22[医药卫生—心血管疾病]