替罗非班用于冠状动脉搭桥手术治疗急性ST段抬高心肌梗死的临床效果研究

doi:10.3969/j.issn.10073205.2018.04.007

河北医科大学学报

替罗非班用于冠状动脉搭桥手术治疗急性ST段抬高心肌梗死的临床效果研究

1.山东省济宁市第一人民医院心外科，山东济宁 272011； 2.河北医科大学第二医院心脏大血管外科，河北石家庄 050000

出版日期:2018-04-25 发布日期:2018-04-23
作者简介:米怀雪（1986-），男，回族，山东济宁人，山东省济宁市第一人民医院医师，医学硕士，从事心脏疾病及大血管疾病诊治研究。

Clinical effect of tirofiban in the treatment of acute ST segment elevation of myocardial infarction on coronary artery bypass surgery#br#

1.Department of Cardiovascular Surgery, the First People′s Hospital of Jinning, Shandong Province,
Jining 272011, China;2.Department of Cardiovascular Surgery, the Second Hospital of Hebei
Medical University, Shijiazhuang 050000, China

Online:2018-04-25 Published:2018-04-23

摘要/Abstract

摘要： ［摘要］〓
〖HTH〗目的〖HTSS〗〖KG*2〗观察替罗非班用于冠状动脉搭桥手术治疗急性ST段抬高心肌梗死患者的临床效果。
〖HTH〗方法〖HTSS〗〖KG*2〗将180例急性ST段抬高心肌梗死患者按照随机原则分为试验组和对照组，对照组在常规治疗基础上应用低分子肝素治疗，试验组在常规治疗基础上应用盐酸替罗非班联合低分子肝素治疗，比较2组脑利钠肽前体(proBNP)、心电图ST段回落幅度、术后超声心动图心功能指标变化情况及主要心血管不良事件。
〖HTH〗结果〖HTSS〗〖KG*2〗术后2组proBNP水平均先升高后降低，试验组趋势小于对照组，2组在组间、时点间、组间·时点间交互作用差异均有统计学意义（P＜005）；心电图ST段回落幅度：术后即刻、1 h、12 h试验组ST段回落程度大于对照组，2组在组间、时点间、组间·时点间交互作用差异均有统计学意义（P＜005）；术后超声心动图心功能指标变化情况：2组术后1周左心室射血分数、左心室舒张末期内径及左心室收缩末期内径差异均无统计学意义(P＞005)，术后4周试验组左心室射血分数、左心室舒张末期内径及左心室收缩末期内径明显优于对照组(P＜005)；试验组顽固心肌缺血、心绞痛发作率低于对照组，差异有统计学意义(P＜005)。
〖HTH〗结论〖HTSS〗〖KG*2〗替罗非班可显著提高冠状动脉搭桥手术治疗急性ST段抬高心肌梗死患者的临床治疗效果。

关键词: 心肌梗死, 替罗非班, 冠状血管

Abstract: ［Abstract］ Objective〖HTSS〗〓To investigate the clinical effect of tirofiban in the treatment of coronary artery bypass surgery in patients with acute ST elevation myocardial infarction.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓According to the principle of random, one hundred and eighty patients with acute ST segment elevation myocardial infarction were divided into experimental group and control group, The control group was treated with low molecular weight heparin on the basis of conventional treatment. The patients in the experimental group were treated with tirofiban and low molecular weight heparin on the basis of routine treatment. The proBNP, ECG, ST segment drop, postoperative echocardiography, cardiac function changes and major adverse cardiovascular events were compared between 2 groups.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓After the operation, the level of 2 groups of proBNP was increased first and then decreased. The trend of the test group was less than that of the control group. There were statistical differences between 2 groups in the intergroup, time point, intergroup time point and time point(P＜005). The ST segment dropping rate of the electrocardiogram was higher than that of the control group at the moment after the operation, and the drop rate of ST in the experimental group 1 h and 12 h was higher than that of the control group after the operation, and the rate of decrease was higher in the experimental group than in the control group(P＜005). Cardiac function index of 2 groups after first weeks of echocardiography: there was no significant difference in left ventricular ejection fraction, left ventricular end diastolic diameter and left ventricular end systolic diameter(P＞005). The left ventricular ejection fraction, the left ventricular end diastolic diameter and the left ventricular end systolic diameter were significantly better than the control group fourth weeks after the operation(P＜005). The intractable myocardial ischemia and angina pectoris in the experimental group were lower than those in the control group, and the difference was statistically significant(P＜005).
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Tirofiban can significantly improve the clinical effect of coronary artery bypass surgery for patients with acute ST segment elevation myocardial infarction.

Key words: myocardial infarction； tirofiban, coronary vessels

米怀雪1，张〓申1*，刘林力2. 替罗非班用于冠状动脉搭桥手术治疗急性ST段抬高心肌梗死的临床效果研究[J]. 河北医科大学学报, doi: 10.3969/j.issn.10073205.2018.04.007.

MI Huaixue1， ZHANG Shen1*， LIU Linli2. Clinical effect of tirofiban in the treatment of acute ST segment elevation of myocardial infarction on coronary artery bypass surgery#br#[J]. Journal of Hebei Medical University, doi: 10.3969/j.issn.10073205.2018.04.007.

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替罗非班用于冠状动脉搭桥手术治疗急性ST段抬高心肌梗死的临床效果研究

Clinical effect of tirofiban in the treatment of acute ST segment elevation of myocardial infarction on coronary artery bypass surgery#br#

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