替奈普酶联合替罗非班对STEMI患者直接PCI术后慢血流、心功能及MACE的影响  

Effects of teneplase combined with tirofiban on slow blood flow,cardiac function and MACE in STEMI patients after direct PCI

作　　者：侯艳艳 秦英华 刘净文 HOU Yanyan;QIN Yinghua;LIU Jingwen(Department of Cardiology,People's Hospital of Hebi,Hebi Henan 458030,China)

机构地区：[1]鹤壁市人民医院心内科,河南鹤壁458030

出　　处：《天津药学》2025年第3期278-281,共4页Tianjin Pharmacy

摘　　要：目的探究替奈普酶联合替罗非班在急性ST段抬高型心肌梗死(STEMI)直接经皮冠状动脉介入治疗(PCI)患者中的临床效果。方法选取鹤壁市人民医院2022年1月至2024年5月收治的98例STEMI直接PCI术患者作为本次研究对象,将其按照01~98的顺序编号,依据单、双数列分组法分为对照组和干预组,每组49例。单数为对照组,给予常规PCI联合术中替罗非班治疗方案;双数为干预组,在对照组基础上联合给予术中替奈普酶治疗方案。对两组患者PCI术后心肌梗死溶栓试验(TIMI)血流分级、治疗前、治疗1个月后,心功能及主要不良心血管事件(MACE)发生率等指标进行对比分析。结果干预组患者PCI术后TIMI分级:0级2例(4.08%)、1级9例(18.37%)、2级13例(26.53%)、3级25例(51.02%);对照组为:0级9例(18.37%)、1级18例(36.73%)、2级14例(28.57%)、3级10例(20.41%),两组对比有统计学差异(P<0.05)。两组患者治疗前心功能各项指标相比无统计学差异(P>0.05);治疗1个月后,干预组左室舒张末期内径(LVEDD)[(36.37±1.53)mm]、左室射血分数(LVEF)[(55.29±1.27)%]均高于对照组(P<0.05);两组患者MACE发生率均为2.04%,组间无统计学差异(P>0.05)。结论对STEMI直接PCI术患者给予术中替奈普酶联合替罗非班治疗方案,可有效改善患者心肌血流灌注水平,明显提高心功能,对患者MACE发生率无明显影响。Objective To explore the clinical efficacy of teneplase combined with tirofiban in patients with acute ST-segment elevation myocardial infarction(STEMI)after direct percutaneous coronary intervention(PCI).Methods Ninety-eight patients with STEMI direct PCI treated in People's Hospital of Hebi from January 2022 to May 2024 were selected as the subjects of this study.They were numbered in the order of 01 to 98,and divided into control group and intervention group according to single and even column grouping method,with 49 cases in each group.The singular group was the control group,which received routine PCI combined with intraoperative tirofiban treatment.Even-number intervention group was the intervention group,which combined with intraoperative teneplase therapy on the basis of control group.Blood flow grading of myocardial infarction thrombolysis test(TIMI),cardiac function before and 1 month after treatment and incidence of major adverse cardiovascular events(MACE)were compared between the two groups.Results TIMI grading after PCI in the intervention group:2 cases(4.08%)in grade 0,9 cases(18.37%)in grade 1,13 cases(26.53%)in grade 2,and 25 cases(51.02%)in grade 3.Control group:9 cases(18.37%)in grade 0,18 cases(36.73%)in grade 1,14 cases(28.57%)in grade 2,10 cases(20.41%)in grade 3,there were statistical differences between the two groups(P<0.05).There were no significant differences in cardiac function indexes between the two groups before treatment(P>0.05).After 1 month of treatment,left ventricular end-diastolic internal diameter(LVEDD)[(36.37±1.53)mm]and left ventricular ejection fraction(LVEF)[(55.29±1.27)%]in intervention group were higher than those in control group(P<0.05).The incidence of MACE was 2.04%in both groups,and there was no significant difference between the two groups(P>0.05).Conclusion The administration of a treatment regimen combining tenecteplase with tirofiban during the procedure for STEMI patients undergoing direct PCI effectively improves myocardial blood perfusion levels and sign

关 键 词：急性ST段抬高型心肌梗死 替奈普酶 替罗非班 慢血流 心功能 主要不良心血管事件 

分 类 号：R541.6[医药卫生—心血管疾病]