【摘要】 目的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。方法将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。结果术后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)。结论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。更多还原

【Abstract】 Objective To investigate the clinical effect of tirofiban in the treatment of coronary artery bypass surgery in patients with acute ST elevation myocardial infarction. Methods 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 proBNP,ECG,ST segment drop,postoperative echocardiography,cardiac function changes and major adverse cardiovascular events were compared between 2 groups. Results 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). Conclusion Tirofiban can significantly improve the clinical effect of coronary artery bypass surgery for patients with acute ST segment elevation myocardial infarction.更多还原