摘要
目的:探究血栓抽吸联合替罗非班+比伐芦定用于ST段抬高型心肌梗死(ST-segment elevation myocardial infarction, STEMI)急诊经皮冠状动脉介入术(percutaneous coronary intervention, PCI)患者的临床效果。方法:按随机数字表法将2022年3月—2024年6月于我院急诊科行PCI治疗的132例STEMI患者分为对照组和试验组,每组66例。对照组予以血栓抽吸和替罗非班治疗,试验组在此基础上加用比伐芦定治疗。比较2组心肌损伤标志物、炎性因子水平、心肌血流灌注、ST段回落率、心功能和安全性。结果:2组术后肌酸激酶同工酶、超敏肌钙蛋白I、B型利钠肽、白细胞介素-6、白细胞介素-1β、细胞间黏附分子-1水平均低于同组术前,左心室后壁厚度、每搏心输出量、左心室射血分数均高于同组术前,且试验组改善程度优于对照组(P<0.05)。试验组ST段回落率、心肌梗死溶栓试验血流Ⅱ~Ⅲ级占比高于对照组,校正的心肌梗死溶栓试验血流帧数低于对照组(P<0.05)。术后随访1个月,试验组总体不良心血管事件发生率低于对照组(P<0.05)。结论:STEMI急诊PCI患者应用血栓抽吸联合替罗非班+比伐芦定治疗能有效减轻血管炎症反应及心肌损伤,提高血流灌注量及心功能,且安全性高。
Objective To investigate the clinical efficacy of thrombus aspiration combined with tirofiban and bivalirudin in emergency percutaneous coronary intervention(PCI) patients with ST-segment elevation myocardial infarction(STEMI).Methods According to the random number table method, 132 STEMI patients who underwent PCI treatment in the emergency department from March 2022 to June 2024 were divided into a control group and an experimental group, with 66 patients in each group. The control group was treated with thrombus aspiration and tirofiban, while the experimental group was treated with bivalirudin on this basis. The levels of myocardial injury markers, inflammatory factors, myocardial blood flow perfusion, ST-segment regression rate, cardiac function and safety between the two groups were compared.Results After surgery, the levels of creatine kinase isoenzyme, high-sensitivity troponin Ⅰ, B-type natriuretic peptide, interleukin-6, interleukin-1β and intercellular adhesion molecule-1 in both groups were lower than before surgery in the same group, while the posterior ventricular wall motion amplitude, stroke volume and the left ventricular ejection fraction were higher than before surgery in the same group, and the degree of improvement in the experimental group was better than that in the control group(P<0.05). The ST-segment regression rate and the proportion of TIMI blood flow grade Ⅱ-Ⅲ in the experimental group were higher than those in the control group, and the number of corrected TIMI blood flow frames was lower than that in the control group(P<0.05). The overall incidence of adverse cardiovascular events in the experimental group was lower than that in the control group during the 1-month follow-up after surgery(P<0.05).Conclusion The application of thrombosis aspiration combined with tirofiban and bivalirudin therapy in emergency PCI patients with STEMI can effectively reduce the vascular inflammation and myocardial injury, improve the blood flow perfusion and cardiac function, and has high safety.
作者
尹可可
赵强
陈春梅
张志远
孙慧
李伟
YIN Keke;ZHAO Qiang;CHEN Chunmei;ZHANG Zhiyuan;SUN Hui;LI Wei(Department of Emergency Surgery,Henan Chest Hospital,Zhengzhou,454000,China)
出处
《临床急诊杂志》
2025年第5期337-342,共6页
Journal of Clinical Emergency
关键词
血栓抽吸
替罗非班
比伐芦定
经皮冠状动脉介入术
ST段抬高型心肌梗死
thrombosis aspiration
tilofiban
bivalirudin
percutaneous coronary intervention
ST-segment elevation myocardial infarction
作者简介
通讯作者:孙慧,E-mail:sung2001@126.com。
