替罗非班对急性非ST段抬高心肌梗死患者血清心肌肌钙蛋白T水平及近期预后的影响

摘要

Objective To investigate the effect of tirofiban on serum cardiac troponin T (cTNT) level and short-term prognosis in patients with acute non-ST-segment elevation myocardial infarction (NSTEMI). Methods Dur-ing January 2016 to January 2017, 68 NSTEMI patients treated in Department of Cardiology in Shenzhen Longhua Peo-ple's Hospital were selected as research objects. According to the random number table, the patients were divided into ob-servation group (n=34) and control group (n=34). The control group was treated by aspirin and clopidogrel antiplatelet therapy, and the observation group applied tirofiban based on the treatment of the control group, both for 7 days. The two groups were compared in dynamic changes of cTNT and complications, major adverse cardiac events (MACE) oc-currence rate. Results In the observation group, cTNT levels after treatment at 12 h and 24 h respectively were (1.74± 0.69)μg/L, (1.45 ± 0.47)μg/L, significantly lower than (2.46 ± 0.95)μg/L, (1.92 ± 0.64)μg/L in the control group (P<0.05);bleeding rate was 14.71％in the observation group and 8.82％in the control group (P>0.05);after follow-up of 30 days, the MACE rate in the observation group was 8.82％, significantly lower than 23.53％in the control group (P<0.05). Conclusion Tirofiban in the treatment of NSTEMI can effectively reduce myocardial injury, improve short-term prognosis, and does not increase the incidence of bleeding and other complications.%目的 探讨替罗非班对急性非ST段抬高心肌梗死(NSTEMI)患者血清心肌肌钙蛋白T(cTNT)水平及近期预后的影响.方法 选择2016年1月至2017年1月期间深圳市龙华区人民医院心内科收治的68例NSTEMI患者为研究对象,根据随机数表法将患者分为观察组和对照组,每组34例,对照组给予阿司匹林联合氯吡格雷抗血小板治疗,观察组在此基础上联合应用替罗非班治疗,疗程均为7 d.比较两组患者治疗后cTNT的动态变化及并发症发生情况、主要心脏不良事件(MACE)发生率.结果 观察组患者cTNT水平在治疗后12 h、24 h时分别为(1.74±0.69)μg/L、(1.45±0.47)μg/L,均明显低于对照组的(2.46±0.95)μg/L、(1.92±0.64)μg/L,差异均有统计学意义(P<0.05);观察组与对照组患者出血发生率分别为14.71％和8.82％,差异无统计学意义(P>0.05);随访30 d,观察组患者MACE发生率8.82％,明显低于对照组的23.53％,差异有统计学意义(P<0.05).结论 替罗非班治疗NSTEMI可以有效减轻心肌损伤、改善近期预后,并且不增加出血等并发症的发生率.