替格瑞洛联合替罗非班在ST段抬高型心肌梗死糖尿病患者急诊PCI术中的应用和安全性

发布时间：2018-03-21 05:08

本文选题：替罗非班　切入点：替格瑞洛　出处：《中国老年学杂志》2017年05期 　论文类型：期刊论文

【摘要】：目的探讨替格瑞洛联合替罗非班在ST段抬高型心肌梗死(STEMI)糖尿病患者急诊经皮冠状动脉介入治疗(PCI)术中的临床疗效和安全性。方法将186例STEMI合并2型糖尿病患者随机分为对照组、替格瑞洛组、联合药物组,比较3组用药前及用药后24 h血小板聚集率的变化,PCI术后即刻冠脉血流TIMI分级、矫正TIMI计帧(CTFC)、心肌染色分级(MBG)、术后90 d心脏超声指标、主要不良心脏事件(MACE)及出血并发症。结果用药24 h后联合药物组血小板聚集率较对照组与替格瑞洛组明显下降(P0.05);联合药物组即刻冠脉血流TIMI分级、CTFC、MBG较对照组、替格瑞洛组明显改善(P均0.05);与对照组、替格瑞洛组比较,联合药物组术后90 d的左室射血分数(LVEF)、心脏指数(CI)、每搏指数(SVI)增加,左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)减少(均P0.05);联合药物组90 d内主要不良心血管事件明显减少(P0.05),出血并发症无明显变化(P0.05)。结论 STEMI合并糖尿病患者PCI术中联合应用替格瑞洛与替罗非班可明显降低血小板聚集功能,提高即刻冠脉血流和心肌微循环水平,改善心功能,减少主要不良心血管事件的发生,且不增加出血风险,具有较好的临床疗效和安全性。
[Abstract]:Objective to investigate the clinical efficacy and safety of tigrilol combined with tirofiban in the emergency percutaneous coronary intervention (PCI) for patients with ST-segment elevation myocardial infarction (STEMI). They were randomly divided into control group, The changes of platelet aggregation rate before and 24 hours after treatment were compared in the tigrilol group and combined drug group. The TIMI grade of coronary blood flow was corrected immediately after PCI, and the myocardial staining grade was evaluated. The echocardiographic parameters were measured 90 days after operation. Results the platelet aggregation rate of the combined drug group was significantly lower than that of the control group and the tigrilol group after 24 hours, and the TIMI grade of the combined group was significantly lower than that of the control group. Compared with the control group and tigrilol group, the left ventricular ejection fraction (LVEFV), cardiac index (CI) and stroke index (SVI) in the combined drug group were increased 90 days after operation, and compared with the control group and the tigrilol group, the left ventricular ejection fraction (LVEF), cardiac index (CI) and stroke index (SVI) were increased. Left ventricular end-systolic diameter (LVESD) and left ventricular end-diastolic diameter (LVEDDD) were decreased (all P 0.05), and the major adverse cardiovascular events in the combined drug group were significantly reduced within 90 days, with no significant change in bleeding complications during PCI operation in patients with STEMI complicated with diabetes mellitus (P 0.05). Combined use of tigrilol and tirofiban could significantly reduce platelet aggregation. Increasing the level of immediate coronary flow and myocardial microcirculation, improving cardiac function, reducing the occurrence of major adverse cardiovascular events, and not increasing the risk of bleeding, has good clinical efficacy and safety.
【作者单位】：武警边防部队总医院心内科;新疆医科大学第一附属医院心内科;
【基金】：国家自然科学基金项目(8126041) 新疆维吾尔自治区科技支疆项目(2013911111)
【分类号】：R542.22;R587.1

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