急诊经皮冠状动脉介入手术冠脉内应用硝普钠与替罗非班治疗老年急性心肌梗死效果及影响因素分析

目的探讨急诊经皮冠状动脉介入手术(Percutaneous Coronary Intervention,PCI)冠脉内应用硝普钠与替罗非班治疗老年急性心肌梗死效果及影响因素分析。方法收集153例急性心肌梗死老年患者,进行急诊PCI冠脉内应用硝普钠与替罗非班治疗(实验组)76例和急诊PCI冠脉内应用硝酸甘油与替罗非班治疗组(对照组)77例。追踪测评患者血清肌钙蛋白Ⅰ(Cardiac TroponinⅠ,cTnⅠ)、谷胱甘肽过氧化物酶(Glutathione,GSH)、超氧化物歧化酶(Superoxide Dismutase,SOD)、N末端B型钠尿肽前体(N-terminalpro-B-typenatriureticpeptide,NT-proBNP)、白介素-6(Interleukin-6,IL-6)、肿瘤坏死因子-α(Tumor Necrosis Factor-α,TNF-α)、内皮素(Endothelin,ET)、一氧化氮(NO)、血栓素B_2(Thromboxane B_2,TXB_2)、6酮-前列腺素F1α(6-keto-prostaglandin F1 alpha,6-keto-PGF1α)以及左心室射血分数(Left Ventricular Ejection Fraction,LVEF)、心肌梗死溶栓试验血流分级(Thrombolysis In Myocardial Infarction,TIMI分级)、心功能改善效果。结果实验组c TnⅠ、GSH、SOD、NT-pro BNP、IL-6、TNF-α、ET、NO、TXB_2、6-keto-PGF1α、LVEF、心功能改善效果、TIMI的追踪组间得分及复测组间得分差异有统计学意义(F=23.129、24.742、25.510、26.048、26.444、25.371、28.320、22.322、25.317、26.372、24.314、24.512、22.147,均P<0.05)。结论急诊PCI冠脉内应用硝普钠与替罗非班治疗老年急性心肌梗死患者对于心功能改善效果显著提高,并其受年龄、身体质量指数(Body Mass Index,BMI)、并发症、病变血管数量以及干预前心功能等级的影响。

Therapeutic effects and influencing factors analysis of Sodium Nitroprusside(SNP)and Tirofiban in elderly Acute Myocardial Infarction(AMI)patients undergoing emergency Percutaneous Coronary Intervention(PCI)

Objective To study the therapeutic effects of SNP and Tirofiban in elderly AMI patients undergoing emergency PCI.Methods A total of 153 cases of AMI patients were divided into two groups:the treatment group consisted of 76 cases with SNP and Tirofiban applied in PCI while the control group consisted of 77 cases with nitroglycerin and Tirofiban applied in PCI.The following factors were measured among all cases:serum Cardiac TroponinⅠ(cTnⅠ),Glutathione Peroxidase(GPx),Superoxide Dismutase(SOD),N-terminal pro-B-type natriuretic peptide(NT-proBNP),Interleukin-6(IL-6),Tumor Necrosis Factor-α(TNF-α),Endothelin(ET),Nitric oxide(NO),Thromboxane B2(TXB2),6-keto-prostaglandin F1-α(6-keto-PGF1-α)and Left Ventricular Ejection Fraction(LVEF),Thrombolysis in Myocardial Infarction Trial(TIMI).Results The scores of CTNⅠ,GPx,SOD,NT proBNP,IL-6,TNF-α,ET,NO,TXB2,6-keto-PGF1-α,LVEF,improvement of heart function and TIMI in the experimental group before and after the first and the second test were statistically significant compared with those in the control group(F=23.129,24.742,25.510,26.048,26.444,25.371,28.320,22.322,25.317,26.372,24.314,24.512,22.147;P<0.05).Conclusion The use of SNP and Tirofiban in elderly AMI patients undergoing emergency PCI treatment significantly improves cardiac function,which subjects to the influence of factors such as age,BMI,complications,the number of diseased vessels and the level of cardiac function before intervention.