替罗非班对急性心肌梗死急诊PCI术后左室重构的影响  

Effect of tirofiban on left ventricular remodeling inacute myocardial infarction after emergency percutaneous coronary intervention

作　　者：朱延鑫 刘中慧 周树龙 王怀新[2] ZHU Yanxin;LIU Zhonghui;ZHOU Shulong;WANG Huaixin(Department of Internal Medicine,Weifang Medical University,Weifang 261053,China;Department of Emergency,Weifang Yidu Central Hospital)

机构地区：[1]潍坊医学院内科学教研室,山东潍坊261053 [2]潍坊市益都中心医院急诊科

出　　处：《潍坊医学院学报》2018年第3期208-210,共3页Acta Academiae Medicinae Weifang

摘　　要：目的探讨急性心肌梗死(AMI)急诊直接经皮冠状动脉介入治疗(PCI)术中应用血小板糖蛋白Ⅱb/Ⅲa受体拮抗剂替罗非班对左心室重构的影响。方法对入选的106例STEMI患者随机分为治疗组(替罗非班)53例和对照组53例。对比观察两组患者在介入治疗后即刻、治疗后1个月、3个月、6个月时左心室重构指标,左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)、左心室舒张末期内径(LVEDd)、左心室收缩末期内径(LVESd)、左心室重量(LVW)、左心室重构指数(LVRI)、左心室重量指数(LVWI)变化。结果治疗组和对照组介入治疗后即刻、1个月、3个月、6个月LVESV、LVEDV、LVEDd、LVESd和LVRI的变化均有统计学意义(P<0.05)。而LVW和LVWI各时间段变化均无统计学意义(P>0.05)。两组比较治疗后6个月LVESV、LVESd差异有统计学意义(P<0.05)。其他各项指标差异无统计学意义(P>0.05)。结论 AMI患者急诊直接PCI术中应用替罗非班可有效抑制左心室重构。Objective To study the effect of platelet glycoprotein IIb/III a receptor antagonist tirofiban on left ventricular remodeling in patients with acute myocardial infarction（AMI） undergoing emergency percutaneous coronary intervention（PCI）. Methods One hundred and six cases of STEMI patients were randomly divided into 53 cases in the treatment group（tiroofiban） and 53 cases in the control group. The indexes of left ventricular remodeling were observed immediately after interventional therapy,1 month,3 months and 6 months after interventional therapy. Left ventricular end-diastolic volume（LVEDVV）,left ventricular end-systolic volume（LVESVN）,left ventricular end-diastolic diameter（LVEDd N）,left ventricular end-systolic diameter（LVESd）,left ventricular weight（LVWN）,left ventricular remodeling index（LVRI） and left ventricular mass index（LVWI） were observed. Results The changes of LVESV,LVEDV,LVEDd,LVESd and LVRI in treatment group and control group were statistically significant at 1 months,3 months,6 months after intervention（P 〈0.05）. There was no statistical significance in the changes of LVW and LVWI（P 〉0.05）. The differences of LVESV and LVESd in the two groups after 6 months of treatment were statistically significant（P 〈0. 05）. There was no significant difference in other indicators（P 〈0.05）. Conclusion Tirofiban in patients with AMIafter primary PCI is more effective in inhibitory action of left ventricular remodeling.

关 键 词：急性ST段抬高型心肌梗死 左心室重构 优化再灌注治疗 替罗非班 

分 类 号：R969.4[医药卫生—药理学]