替罗非班对急性心肌梗死患者经皮冠状动脉介入术后心肌损伤及预后的影响

目的 探讨替罗非班对急性心肌梗死(AMI)患者冠状动脉介入术(PCI)后心肌损伤及预后的影响.方法 将120例拟行PCI的AMI患者完全随机分为对照组与观察组,每组60例,观察组患者在行PCI术前使用替罗非班.比较2组术后6、12 h的心肌肌钙蛋白T(cTnT)、心肌型肌酸激酶同工酶(CK-MB)水平,术后30 min心肌梗死溶栓试验(TIMI)血流情况,术后30d主要心脏事件发生率及超声心动图指标.结果 与对照组比较,观察组术后6、12 h的cTnT[( 1.54±0.35)mg/L比(2.16 ±0.57)mg/L,(1.18±0.65)mg/L比(1.69±0.76)mg/L]、CK-MB[ (32±7)U/L比(46±8)U/L,(31±6)U/L比(42 ±6) U/L]水平明显低(均P＜0.05);术后30d观察组心脏事件发生率[11.7％(7/60)]明显少于对照组[21.7％( 13/60)](P＜0.05);术后30 min观察组TIMI3级患者比例[96.7％ (58/60)]明显高于对照组[86.7％(52/60)](P＜0.05);术后30d观察组心脏彩超左心室射血分数明显高于对照组[ (66±9)％比(53±7)％],左心室收缩末期容积[(30±4)ml比(38±5)ml]、左心室舒张末期容积[(45 ±4)ml比(54±5)ml]明显低于对照组(均P＜0.05).结论 AMI行PCI患者术前给予替罗非班可明显减轻心肌损伤,改善心肌灌注及患者预后.

Impact of tirofiban on myocardial damage and prognosis after pereutaneous coronary intervention in patients with acute myocardial infarction_

Objective To explore the effect of tirofiban on myocardial damage and prognosis after pereuta- neous coronary intervention （PCI） in patients with acute myocardial infarction （AMI）. Methods All 120 patients with AMI undergoing PCI were randomly divided into observation group and control group with 60 cases in each group. Serum cardiac troponin T（cTnT）, creatine kinase-MB （CK-MB） level on 6 hour and 12 hour after opera- tion, thrombolysis in myocardial infarction（TIMI） on 30 minutes postoperative, occurrence of major adverse cardiac event and echocardiography index 30 days after operation were compared between two groups. Results Serum cTnT, CK-MB level on 6 hour and 12 hour after operation in observation group were much lower than those in control group [cTnT.（1.54±0.35）g/L vs （2.16±0.57）g/L,（1.18±0.65）g/L vs （1.69±0.76）g/L; CK-MB： （32±7 ） U/L vs （46±8 ） U/L, （ 31±6 ） U/L vs （42±6 ） U/L, all P 〈 0.05 ] ; occurrence of major adverse cardiac event 30 days after intervention were 11.7% （7/60）and 21.7% （13/60） respectively in observation group and control group, with significant differences （ P 〈 0.05 ） ; the patients of TIMI grade 3 on 30 minutes postoperation in observa- tion group were more than those in control group [ 96.7% （58/60）vs 86.7% （52/60） ] ; compared to control group, left ventricular ejection fraction （LVEF） was higher [ （66±9 ）% vs （53±7 ）% ], and left ventricular end-systolic volume （LVESV） [ （ 30±4） ml vs （38±5 ） ml ] and left ventricular end-diastolic volume （LVEDV） [ （45±4） ml vs （54±5） ml vs 30 days after treatment in observation group were lower （ all P 〈 0.05）. Conclusion Tirofiban administration in patients with AMI before PCI can greatly decrease myocardial damage and improve repeffusion and patients＇ prognosis.