曲美他嗪联合替罗非班对接受介入治疗的急性ST段抬高型心肌梗死患者心肌的影响  

Effects of Trimetazidine Combined with Tirofiban on Myocardial Protection in Patients with Acute ST Segment Elevation Myocardial Infarction After Interventional Therapy

作　　者：王素娟[1] 杨萌萌[1] 李新洁[1] WANG Sujuan;YANG Mengmeng;LI Xinjie(Department of Cardiology,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,China)

机构地区：[1]河南科技大学第一附属医院心内科,河南洛阳471000

出　　处：《河南医学研究》2021年第20期3777-3780,共4页Henan Medical Research

摘　　要：目的探讨曲美他嗪联合替罗非班对接受介入治疗的急性ST段抬高型心肌梗死(STEMI)患者心肌的影响。方法选取2018年8月至2020年8月河南科技大学第一附属医院收治的110例接受急性STEMI介入治疗患者作为研究对象,根据治疗方式分为对照组与观察组,各55例。对照组接受常规治疗联合替罗非班,观察组接受常规治疗、替罗非班联合曲美他嗪治疗。比较两组心肌损伤指标、微循环障碍情况、心功能;随访6个月,记录患者再发心绞痛及再入院情况。结果术前,两组肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白(cTnⅠ)水平比较,差异无统计学意义(P>0.05);术后24 h,两组CK-MB、cTnⅠ水平均降低,且观察组低于对照组,差异有统计学意义(P<0.05)。术前,两组灌注造影时峰值强度(PI)、振幅(A)、曲线上升斜率(β)水平比较,差异无统计学意义(P>0.05);术后3 d,两组PI、A、β水平均降低,且观察组低于对照组,差异有统计学意义(P<0.05)。术前,两组左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、左心室射血分数(LVEF)水平比较,差异无统计学意义(P>0.05);术后3 d,两组LVEDD、LVESD水平降低,LVEF水平升高,且观察组LVEDD、LVESD低于对照组,LVEF高于对照组,差异有统计学意义(P<0.05)。随访6个月,观察组再发心绞痛发生率、再入院发生率均低于对照组,差异有统计学意义(P<0.05)。结论曲美他嗪联合替罗非班可保护急性STEMI介入治疗心肌功能,改善心肌微循环障碍及心功能,降低再发心绞痛及再入院发生率。Objective To investigate the effects of trimetazidine combined with tirofiban on myocardial protection in patients with acute ST segment elevation myocardial infarction(STEMI)after interventional therapy.Methods A total of 110 patients with acute STEMI after interventional therapy who were treated in the First Affiliated Hospital of Henan University of Science and Technology from August 2018 to August 2020 were retrospectively selected,they were divided into control group and observation group according to treatment methods,with 55 cases in each group.The control group accepted conventional treatment and tirofiban,the observation group accepted conventional treatment,tirofiban and trimetazidine.The indexes of myocardial injury,microcirculation disturbance and cardiac function were compared between the two groups.After 6 months’follow-up,the recurrence of angina pectoris and readmission of patients were recorded.Results Twenty-four hours after operation,the levels of creatine kinase isoenzyme(CK-MB)and cardiac troponin I(cTnⅠ)of two groups were lower than those of before operation,and the levels of CK-MB and cTnⅠof the observation group were lower than those of the control group(P<0.05).Three days after operation,the levels of peak intensity(PI),amplitude(A)and the slope of curve rise(β)of two groups were lower than those of before operation,and the levels of PI,A andβof the observation group were lower than those of the control group(P<0.05).Three days after operation,the levels of left ventricular end diastolic diameter(LVEDD)and left ventricular end systolic diameter(LVESD)of two groups were lower than those of before operation,and the levels of left ventricular ejection fraction(LVEF)were higher than those of before operation(P<0.05).After 6 months’follow-up,the incidence of recurrent angina pectoris and readmission of the observation group were lower than those of the control group(P<0.05).Conclusion Trimetazidine combined with tirofiban can protect myocardial function,improve myocardial microcircul

关 键 词：急性ST段抬高型心肌梗死 介入治疗 曲美他嗪 替罗非班 心肌保护 

分 类 号：R542.22[医药卫生—心血管疾病]