作　　者： (李晓莉）; (金光）;

机构地区： 新疆喀什地区第一人民医院,新疆喀什844000

出　　处： 《内科急危重症杂志》 2017年第4期315-317,共3页

摘　　要： 目的:探讨急诊经皮冠状动脉介入术(PCI)与替罗非班联合治疗急性心肌梗死患者(AMI)心肌损伤、内皮功能及心功能的影响。方法:选取97例AMI患者作为研究对象,根据随机数字表法分为观察组(50例)和对照组(47例)。2组患者均接受常规PCI术,观察组在PCI术后给予替罗非班注射液。比较2组患者治疗前、后血中肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I(cTnI)、可溶性细胞黏附因子-1(sICAM-1)、可溶性血管细胞黏附分子1(sVCAM-1)水平及心功能指标。结果:2组PCI术后12h CK-MB较术前显著升高(P<0.05),观察组低于对照组,2组术后12、24 h的cTnI均较术前显著升高(均P<0.05),且观察组cTnI低于对照组(P<0.05)。2组术后24、72 h的sICAM-1、sVCAM-1水平均比术前升高(均P<0.05),且低于对照组(P<0.05)。术后7、30 d 2组左室射血分数(LVEF)均显著高于术前,左室舒张末期内径(LVEDD)以及左室收缩末期内径(LVESD)均显著小于术前(均P<0.05);且观察组的LVEF显著高于对照组,LVEDD、LVESD显著小于对照组(均P<0.05)。结论:PCI与替罗非班联合治疗对AMI患者的心肌损伤、内皮功能及心功能均有明显改善作用。 Objective： To investigate the effect of combined therapy of emergency percutaneous coronary intervention（ PCI） and tirofiban on myocardial injury,endothelial function and cardiac function in patients with acute myocardial infarction（ AMI）. Methods： Ninety-seven patients with AMI were selected as the subjects,and divided into observation group and control group by the random number table. All patients in two groups were treated with conventional PCI,and those in the observation group were given tirofiban additionally after PCI. The levels of creatine kinase-MB（ CK-MB）,cardiac troponin I（ cTnI）,soluble intercellular adhesion molecule-1（ sICAM-1）,soluble vascular cell adhesion molecule-1（ sVCAM-1） and cardiac function were compared between the two groups before and after treatment. Results Twelve h after operation,CK-MB level in the two groups was significantly higher than that before operation（ P〈0. 05）,and that in observation group was lower than in control group. cTnI level at 12 and 24 h after operation was significantly higher than that before operation（ P〈0. 05）,and that in observation group was lower than in control group（ P〈0. 05）. The sICAM-1 and sVCAM-1 levels at 24 and 72 h after operation in two groups were higher than those before operation（ P〈0. 05）,and those at 24 and 72 h after operation in observation group were lower than those in control group（ P〈0. 05）. The LVEF at 7th and 30th day after operation in the two groups was significantly higher than that before operation,and LVEDD and LVESD were significantly lower than those before operation（ P〈0. 05）. The LVEF at 7th and 30th day after operation in observation group was significantly higher than that in control group（ P〈0. 05）. At 30th day after operation,LVEDD and LVESD in observation group were significantly lower than those in control group（ P〈0. 05）. Conclusion： The effects of combination of PCI and tirofiban on myocardial injury,endothelial function and cardiac functi

关 键 词： 急诊 经皮冠状动脉介入术 替罗非班 急性心肌梗死