【摘要】 目的:观察盐酸替罗非班对急性心肌梗死的临床疗效及相应机制。方法:哈尔滨医科大学附属第四医院急诊急救中心入选急性ST段抬高型心肌梗死的患者(n=50),其中男性35例,女性15例,平均年龄58.4±10.3岁,给予内科药物治疗。患者随机分为常规药物组(n=23)和替罗非班组(常规药物+替罗非班,n=27)。通过观察临床症状和心电图ST段变化评价治疗效果,应用血小板聚集仪比浊法测定样本不同时间点(治疗前,给药过程中,给药结束后2小时)血小板聚集率变化以及应用酶联免疫吸附剂测定(ELISA)方法检测血清中血小板第四因子(PF4)的水平变化。并进一步做相关性分析。结果:与常规药物组比较,替罗非班组患者胸痛明显减轻,心电图ST回落指数增加(P<0.05),给药过程中血小板聚集率明显降低(P<0.001),同时血清中PF4的水平也显著降低(P<0.001),并且与血小板聚集率呈正相关性(r=0.86,P<0.001)。结论:盐酸替罗非班对于急性ST段抬高型急性心肌梗死有确切的治疗效果,可能是通过抑制血小板的聚集和减少PF4的释放而发挥作用的。更多还原

【Abstract】 Objective:To observe the clinical efficacy and mechanism of hydrochloricacid for tirofiban in acute myocardia linfarction.Methods:The Fourth Affiliated Hospital of Harbin Medical Center emergency first aid selected patients with acute ST-segment elevation myocardial infarction(n = 50),35 males and 15 females,mean age of 58.4±10.3 years,for medical therapy.Assess the curative effect by observing the clinical symptoms and ECG ST-segment changes.The platelet aggregation analyzer turbidimetric method samples were applied to detect the platelet aggregation changes at different time points(before treatment,administration of the process,administered after 2 hours),and enzyme-linked immunosorbent assay(ELISA) was used to detect serum platelet fourth factor(PF4) level changes.And further to do correlation analysis.Results:Compared with the conventional drug group,tirofiban significantly reduced the chest pain,increased ECG ST drop index(P <0.05),decreased the platelet aggregation rate during the administration(P<0.001).While serum levels of PF4 were also significantly lowered(P <0.001),and positively correlated with platelet aggregation rate(r = 0.86,P <0.001).Conclusion:Tirofiban hydrochloride had curative effect on acute ST-segment elevation myocardial infarction,probably by inhibiting platelet aggregation and reducing the release of PF4.更多还原