替罗非班在急性前壁心肌梗死合并糖尿病患者介入治疗中不同用药途径疗效差异研究  

Study on the efficacy of tirofiban in its different ways of interventional treatment in patients with acute anterior wall myocardial infarction complicated with diabetes mellitus

作　　者：张婷 王祥贺 汤秀英[3] 李玉兰[1] 曹雪滨[2] Zhang Ting;Wang Xianghe;Tang Xiuying;Li Yulan;Cao Xuebin(Department of Geriatrics,Baoding NO.1 Central Hospital,Baoding 071000,China;Department of Cardiology and Nephrology,Hospital of 82nd Group Army of PLA,Baoding 071000,China;Department of Cardiovascular Medicine,Qinhuangdao First Hospital,Qinhuangdao 066000,China)

机构地区：[1]河北省保定市第一中心医院老年病科,河北保定071000 [2]中国人民解放军陆军第八十二集团军医院心肾内科,河北保定071000 [3]秦皇岛市第一医院心血管内科,河北秦皇岛066000

出　　处：《长春中医药大学学报》2022年第5期543-547,共5页Journal of Changchun University of Chinese Medicine

基　　金：河北省科技计划项目(1727777D)。

摘　　要：目的探讨替罗非班在急性前壁心肌梗死合并糖尿病患者介入治疗中不同用药途径的疗效差异。方法选择急性前壁心肌梗死伴糖尿病并行急诊介入治疗患者200例,随机分为冠脉内推注替罗非班组(研究组)及静脉推注替罗非班组(对照组),各100例。比较2组TIMI血流分级、心电图回落程度、心绞痛发作次数、心功能指标、NT-ProBNP、ESR、CRP、CK-MB、TNI、Cre、Ure水平以及住院期间不良事件发生情况、安全性指标。结果术后研究组TIMI血流3级人数高于对照组。研究组心电图回落程度高于对照组(P<0.05)。治疗后,2组心绞痛发作持续时间均明显缩短,研究组治疗后3 d、7 d心绞痛发作持续时间低于对照组(P<0.05);2组LVEF增加,LVEDD降低(P<0.05),且研究组LVEF水平高于对照组,LVEDD低于对照组(P<0.05);2组BNP、ESR、CRP水平显著下降(P<0.05),且研究组NT-ProBNP、ESR、CRP的水平低于对照组(P<0.05);2组血清CK-MB及TNI水平均显著下降(P<0.05),且研究组血清CK-MB及TNI水平显著低于对照组(P<0.05)。2组住院期间不良事件发生率比较,研究组无病死病例,对照组出现2例病死,2组无再次血运重建、新发心肌梗死出现。2组安全性指标比较,研究组出现2例出血,对照组出现1例心绞痛、8例出血。2组组间比较差异无统计学意义(P>0.05)。结论替罗非班在急性前壁心肌梗死伴糖尿病行急诊介入治疗中,疗效较好,与静脉推注替罗非班相比,冠脉内推注替罗非班疗效更佳,且安全性较好,对肾功能指标改善效果较好。Objective To investigate the efficacy of tirofiban in its different ways of interventional treatment in patients with acute anterior wall myocardial infarction complicated with diabetes mellitus.Methods A total of 200 patients with acute anterior wall myocardial infarction complicated with diabetes who underwent an emergency interventional treatment were selected and randomly divided into an intracoronary tirofiban bolus injection group(the study group)and an intravenous tirofiban bolus injection group(the control group),with 100 cases in each group.The indexes of the TIMI blood flow grade,degree of ECG resolution,number of angina pectoris attacks,cardiac function,the levels of NT-ProBNP,ESR,CRP,CK-MB,TNI,Cre,Ure,as well as the adverse event and safety indexes during hospitalization were compared between the two groups.Results After surgery,the number of the patients with grade 3 TIMI blood flow in the study group was higher than that in the control group,and the degree of ECG resolution in the study group was higher than that in the control group(P<0.05).After treatment,the duration of angina pectoris attacks in both groups was significantly shortened,and the duration on the third day and the seventh day in the study group was shorter than that in the control group(P<0.05).After treatment,the level of LVEF was increased while the level of LVEDD was decreased in both groups(P<0.05),and the LVEF level in the study group was higher than that in the control group,while the LVEDD level was lower than that in the control group(P<0.05).After treatment,the levels of BNP,ESR and CRP in the two groups were significantly decreased(P<0.05),and the levels of NT-ProBNP,ESR and CRP in the study group were lower than those in the control group(P<0.05).After treatment,the levels of serum CK-MB and TNI in both groups were significantly decreased(P<0.05),and the study group was significantly lower than the control group(P<0.05).In the comparison of adverse events during hospitalization between the two groups,there were no deaths i

关 键 词：替罗非班 急性前壁心肌梗死合并糖尿病 介入治疗 不同用药 

分 类 号：R54[医药卫生—心血管疾病]