替罗非班对ST段抬高心肌梗死后早期介入患者心肌灌注及心肾的影响

摘要

目的：：探讨替罗非班对ST段抬高心肌梗死后早期介入患者心肌灌注及心肾的影响。方法：选择2015年1月至2016年1月本院收治的急性心肌梗死患者100例，随机分为两组，各50例，观察组联合使用替罗非班，对照组采用低分子肝素，比较两组干预前后心脏彩色多普勒结果、干预前后3d脑钠素及肾功能及治疗期间不良反应。结果：左室射血分数大于干预前，干预后1周观察组左室舒张末期内径、左室收缩末期内径小于对照组，差异具有统计学意义(P<0.05)，左室射血分数大于对照组，差异具有统计学意义(P<0.05)，干预后观察组BNP 水平低于对照组，差异具有统计学意义(P<0.05)，干预后1周两组血肌酐及尿素氮均低于干预前，差异具有统计学意义(P<0.05)，且干预后1周观察组血肌酐及尿素氮低于干预后对照组，差异具有统计，学意义(P<0.05)，观察组发生消化道出血、皮肤瘀斑及大便隐血等的总比例低于对照组，差异具有统计学意义( P<0.05)。结论：替罗非班对ST段抬高心肌梗死后早期冠脉介入治疗患者，可改善其心肌灌注，保护心脏及肾脏功能。%Objective: To investigate the influence of tirofiban on patients with ST segment elevation myocardial perfusion and heart and kidney in ST-segment elevation myocardial infarctionly early intervention. Methods:100 patients with acute myocardial infarction admitted to our hospital from January 2015 to January 2016 were randomly divided into two groups, each with 50 cases. The control group was treated with low mo-lecular weight heparin, and the observation group was treated with low molecular weight heparin combined with tirofiban. The cardiac color doppler findings, intervention and post-intervention three days before brain natri-uretic peptide in renal function during the course of treatment and adverse reactions were compared before and after the intervention. Results:1 week after intervention, both the left ventricular end diastolic diameter and the left ventricular end systolic diameter were less than before intervention ( P<0.05) . The left ventricular e-jection fraction was greater than pre-intervention and post-intervention group, The left ventricular ejection fraction was greater than that in the control group ( P<0.05) . BNP levels in the observation group after inter-vention were lower than that in the control group (P<0.05). The levels of creatinine and urea nitrogen after one week intervention were lower than before intervention ( P<0.05) , and after one week intervention the level of serum creatinine and blood urea nitrogen in the observation group was lower than that in the control group after the intervention ( P<0.05) . The rate of gastrointestinal bleeding, bruising and skin the total proportion of fecal occult blood or the like significantly of observation group was lower than that in the control group ( P<0. 05) . Conclusion:Tirofiban on the patients with ST segment elevation myocardial infarction after early coro-nary intervention can significantly improve the myocardial perfusion and protect the heart and kidney function.