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目的探究冠状动脉球囊扩张术中注射替罗非班对急性心肌梗死患者内皮功能及早期心功能的影响。方法 80例急性心肌梗死患者,随机分为观察组(冠状动脉球囊扩张术中给予替罗非班注射治疗)及对照组(常规进行冠状动脉球囊扩张术治疗),各40例,对比两组临床治疗总有效率、TIMI血流分级、内皮功能及早期心功能。结果治疗后观察组总有效率为97.5%,显著高于对照组的85.0%,差异具有统计学意义(P<0.05)。观察组TIMI血流分级情况明显优于对照组,差异具有统计学意义(P<0.05)。术前两组各内皮功能指标对比,差异无统计学意义(P>0.05)。术后对照组可溶性细胞黏附因子1(s ICAM-1)为(34.6±4.7)μg/L、可溶性血管细胞黏附分子1(s VCAM-1)为(40.6±4.0)μg/L、血管性血友病因子(v WF)为(723.5±123.4)U/L、炎症反应标志物超敏C反应蛋白(hs-CRP)为(7.4±2.1)mg/L均显著高于观察组的(23.5±4.1)μg/L、(24.3±2.3)μg/L、(534.2±112.3)U/L、(6.2±2.0)mg/L,差异具有统计学意义(P<0.05)。术前两组各心功能指标对比差异无统计学意义(P>0.05)。观察组术后左心室舒张末期内径(LVEDD)为(50.2±4.9)mm,左心室射血分数(LVEF)为(52.3±5.4)%显著优于对照组的(54.8±3.6)mm、(48.7±3.9)%,差异具有统计学意义(P<0.05)。结论急性心肌梗死患者冠状动脉球囊扩张术中采用替罗非班注射治疗,可显著改善患者内皮功能与早期心功能,效果显著。
Objective To investigate the effects of tirofiban on endothelium function and early cardiac function in patients with acute myocardial infarction undergoing coronary artery balloon dilatation. Methods Eighty patients with acute myocardial infarction were randomly divided into observation group (given tirofiban injection during coronary artery balloon dilation) and control group (routine coronary artery balloon dilation), 40 cases in each group, The total effective rate of clinical treatment, TIMI flow classification, endothelial function and early cardiac function. Results After treatment, the total effective rate of the observation group was 97.5%, which was significantly higher than that of the control group (85.0%), the difference was statistically significant (P <0.05). TIMI grade in the observation group was significantly better than that in the control group, the difference was statistically significant (P <0.05). There was no significant difference in the endothelial function between the two groups before operation (P> 0.05). The levels of s ICAM-1, sVCAM-1 and sICAM-1 in the control group were (34.6 ± 4.7) μg / L and (40.6 ± 4.0) μg / L and The vWF was (723.5 ± 123.4) U / L and the level of inflammatory response marker hs-CRP was (7.4 ± 2.1) mg / L, which was significantly higher than that of the observation group (23.5 ± 4.1) μg / L, (24.3 ± 2.3) μg / L, (534.2 ± 112.3) U / L, and (6.2 ± 2.0) mg / L respectively. There was significant difference between the two groups (P <0.05). There was no significant difference in cardiac function indexes between the two groups before operation (P> 0.05). The postoperative left ventricular end-diastolic diameter (LVEDD) and left ventricular ejection fraction (LVEF) in the observation group were significantly higher than those in the control group (52.3 ± 5.4)% vs (48.8 ± 3.6) mm ± 3.9%), the difference was statistically significant (P <0.05). Conclusion Tirofiban injection in patients with acute myocardial infarction can significantly improve endothelial function and early cardiac function in patients with coronary artery disease, the effect is significant.