半剂量替罗非班辅助PCI术治疗老年急性ST段抬高心肌梗死的疗效与安全性  

Efficacy and safety of half dose tirofiban assisted PCI for elderly patients with acute ST segment elevation myocardial infarction

作　　者：杨丽[1] 刘庆力 Yang Li;Liu Qing-li(Department of Cardiovascular Medicine,The First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,Henan,China)

机构地区：[1]河南科技大学第一附属医院心血管内科,河南洛阳471000

出　　处：《四川生理科学杂志》2024年第3期487-489,492,共4页Sichuan Journal of Physiological Sciences

基　　金：2021年度河南省医学科技攻关计划联合共建项目(LHGJ20210584)。

摘　　要：目的:研究半剂量替罗非班辅助经皮冠状动脉介入治疗(Percutaneous coronary intervention,PCI)术治疗老年急性ST段抬高心肌梗死(ST-segment elevation myocardial infarction,STEMI)的疗效与安全性.方法:选择2022年1月至12月在我院接受治疗的98例老年急性STEMI患者作为研究对象,按照随机对照原则分为对照组和研究组,各49例.其中对照组采用全剂量替罗非班辅助PCI术治疗,研究组采用半剂量替罗非班辅助PCI术治疗.比较两组心功能、血管内皮功能、炎症反应、不良事件及出血事件的发生情况.结果:治疗1 m m后,两组左心室舒张末期内径(Left ventricular end diastolic diameter,LVEDD)、左心室收缩末期内径(Left ventricular end systolic diameter,LVESD)、内皮素-1(Endothelin-1,ET-1)、血管性假血友病因子(Von Willebrand factor,vWF)、白介素(Interlenkim-6,IL-6)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、超敏C反应蛋白(High-sensitivity C-reactive protein,hs-CRP)均明显降低,而左心室射血分数(Left ventricular ejection fraction,LVEF)、一氧化氮(Nitric oxide,NO)均明显升高(P<0.05),但两组之间均无明显差异(P>0.05).研究组出血事件发生率明显低于对照组(P<0.05).研究组其他不良事件发生率与对照组无明显差异(P>0.05).结论:老年急性STEMI患者采用半剂量替罗非班辅助PCI术治疗不会影响疗效,但可有效降低出血风险,安全性较高.Objective:To investigate the efficacy and safety of half-dose tirofiban combined with percutaneous coronary intervention(PCI)in the treatment of elderly patients with acute ST segment elevation myocardial infarction(STEMI).Methods:A total of 98 elderly patients with acute STEMI who were treated in our hospital from January to December 2022 were selected as the research objects,and were randomly divided into control group and study group,with 49 cases in each group.The control group was treated with full-dose tirofiban assisted PCI,and the research group was treated with half-dose tirofiban assisted PCI.The cardiac function,vascular endothelial function,inflammatory reaction,adverse events and bleeding events were compared between the two groups.Results:After one month of treatment,left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),endothelin-1(ET-1),von Willebrand factor(vWF),interleukin(IL-6),tumor necrosis factor-α(TNF-α)and hypersensitive C-reactive protein(hs-CRP)were measured in both groups.HsCRP decreased,while left ventricular ejection fraction(LVEF)and nitric oxide(NO)increased significantly,but there was no significant difference between the two groups(P>0.05).The incidence of bleeding in the study group was significantly lower than that in the control group(P<0.05).There was no significant difference in the incidence of other adverse events between the study group and the control group(P>0.05).Conclusion:Half dose tirofiban assisted PCI in elderly patients with acute STEMI will not affect the efficacy,but it can effectively reduce the risk of bleeding,with high safety.

关 键 词：老年急性ST段抬高心肌梗死 PCI术 替罗非班 半剂量 安全性 

分 类 号：R542.22[医药卫生—心血管疾病]