盐酸替罗非班对ST段抬高急性心肌梗死近期预后及心肌标志物的影响

摘要

目的 盐酸替罗非班对ST段抬高急性心肌梗死近期预后及心肌标志物的影响.方法 选择明确诊断为ST段抬高性心肌梗死患者334例,随机分为实验组和对照组,每组167例.实验组采用盐酸替罗非班治疗,对照组采用常规治疗,比较2组治疗前后的生化指标、心肌标志物水平及心功能情况.结果 实验组的总有效率为165例(98.80%),显著高于对照组的总有效率150例(89.82%)(χ2=12.556,P<0.05).治疗后,实验组肌钙蛋白I(cardiac troponin I,cTnI)水平显著低于对照组(P<0.05).实验组患者左室舒张末容积(left ventricular end diastolic volume,LVEDV)、左室收缩末期容积(left ventricular endsystolic volume,LVESV)均较对照组明显降低,左室射血分数(left ventricular ejection fraction,LVEF)较对照组明显升高,差异具有统计学意义(P<0.05).实验组全球急性冠状动脉事件注册危险评分(global registry of acute coronary events,GRACE)评分显著低于对照组,差异具有统计学意义(P<0.05).实验组发生心肌梗死溶栓治疗血流分级(thrombolysis in myocardial infarction,TIMI)轻度出血率为5例(2.99%),显著低于对照组的19例(11.38%),差异具有统计学意义(χ2=8.799,P<0.05).治疗后12个月,实验组心绞痛症状发作次数为(1.78±0.78)次,显著低于对照组的(2.56±1.04)次(P<0.05).结论 ST段抬高型急性心肌梗死患者应早诊断,并根据患者个体情况等确定治疗策略,选择适合的盐酸替非罗班用量,以达到良好的治疗效果.%Objective To explore the short-term prognosis of tirofiban hydrochloride on the patients with acute ST-segment elevation myocardial infarction and the influence of tirofiban hydrochloride on myocardial biomarkers. Methods 334 patients with acute ST-segment elevation myocardial infarction were choosen. They were divided into two groups, 167 cases in each group. Tirofiban hydrochloride was used in the experimental group, and conventional therapy was carried out for control group. Compared the biochemical indexes, myocardial biomarkers and cardiac function of the two groups. Results The effective rate of experimental group was 165 cases (98.80%), which was higher than 150 cases (89.82%) in the control group (χ2=12.556,P<0.05). After treatment, the cardiac troponin I (cTnI) in experimental group was lower than control group (P<0.05). The levels of left ventricular end diastolic volume (LVEDV) and left ventricular endsystolic volume (LVESV) significantly decreased and the level of left ventricular ejection fraction (LVEF) increased in experimental group compared with those in control group(P<0.05).The global registry of acute coronary events (GRACE) after treatment in experimental group was lower than that in control group (P<0.05). The hyporrhea of thrombolysis in myocardial infarction (TIMI) in experimental group were 5 cases (2.99%), which was lower than 19 cases (11.38%) in control group (χ2=8.799,P<0.05). After 12 months, the attack frequency of angina in experimental group was (1.78±0.78)times, which was lower than (2.56±1.04) times in control group (P<0.05). Conclusion Patients with acute ST-segment elevation myocardial infarction should be diagnosed as soon as possible and take treatment strategies according to individual situation to chose suitable dosage of tirofiban hydrochloride for good therapeutic effect.