替罗非班联合呋塞米对急性心肌梗死伴心力衰竭患者行急诊PCI后临床预后的影响

唐茜; 王玉; 程景林

doi:10.13201/j.issn.1009-5918.2021.07.001

替罗非班联合呋塞米对急性心肌梗死伴心力衰竭患者行急诊PCI后临床预后的影响

- 1. 安徽医科大学第二附属医院急诊内科(合肥, 230601);
- 2. 安徽医科大学第二附属医院肾脏内科

详细信息

通讯作者: 程景林,E-mail:chjl201102@163.com

中图分类号: R542.2

收稿日期: 2021-03-08

Effect of tirofiban combined with furosemide on clinical prognosis of patients with acute myocardial infarction and heart failure after emergency PCI

- 1. Department of Emergency Medicine, Second Affiliated Hospital of Anhui Medical University, Hefei, 230601,, China;
- 2. Department of Nephrology, Second Affiliated Hospital of Anhui Medical University

More Information

Corresponding author: CHENG Jinglin, E-mail: chjl201102@163.com

Received Date: 08 March 2021

摘要

摘要: 目的:分析替罗非班联合呋塞米对急性心肌梗死(AMI)伴心力衰竭患者行急诊经皮冠状动脉介入(PCI)后临床预后的影响。方法:选取我院2017年1月—2019年3月期间收治的80例AMI伴心力衰竭患者,随机分为观察组、对照组,各40例,均行急诊PCI,并在对症治疗的基础上给予小剂量呋塞米静脉注射,观察组加用替罗非班。对比两组患者心功能变化及术后再灌注指标的差异,并对比其术后6个月内主要不良心血管事件(MACE)发生情况。结果:两组PCI术后30 d LVEF、LVEDD、LVESD与术后7 d检测结果比较,差异无统计学意义(P>0.05),观察组术后7 d、术后30 d LVEF高于同期对照组,LVEDD、LVESD均低于同期对照组,差异有统计学意义(P<0.05)。观察组术后即刻校正心肌梗死溶栓试验(TIMI)帧数低于对照组,其ST段回落>50%占比高于后者,差异有统计学意义(P<0.05)。观察组失访1例,对照组失访3例,其他患者均获得有效随访,随访时间均≥6个月。观察组随访期间MACE发生率为2.56%,低于对照组的21.62%,差异有统计学意义(P<0.05)。结论:对于AMI伴心力衰竭患者而言,急诊PCI术中及术后联合应用替罗非班能够改善左室功能、提高心肌再灌注水平,有助于降低患者术后MACE发生风险。
- 替罗非班 /
- 呋塞米 /
- 急性心肌梗死 /
- 心力衰竭 /
- 经皮冠状动脉介入
Abstract: Objective: To analyze the effect of tirofiban combined with furosemide on the clinical prognosis of patients with acute myocardial infarction(AMI) and heart failure after emergency percutaneous coronary intervention(PCI).Methods: Eighty patients with AMI complicated with heart failure in our hospital from January 2017 to March 2019 were selected and randomly divided into observation group and control group, 40 cases in each group. All patients underwent emergency PCI, and on the basis of symptomatic treatment, low-dose furosemide was given intravenous injection, and tirofiban was added to the observation group. The changes of cardiac function and postoperative reperfusion indexes were compared between the two groups, and the occurrence of major adverse cardiovascular events(MACE) within 6 months after operation were compared.Results: The LVEF, LVEDD and LVESD of the two groups at 30 d after PCI were not significantly different from those at 7 d after PCI(P>0.05). LVEF of the observation group was higher than that of the control group at 7 d and 30 d after PCI, while LVEDD and LVESD of the observation group were lower than those of the control group(P<0.05). The number of TIMI frames in the observation group was lower than that in the control group, and the percentage of ST segment resolution>50% in the observation group was higher than that in the control group(P<0.05). One case was lost in the observation group and three cases in the control group. The other patients were followed up for more than 6 months. The incidence of MACE was 2.56% in the observation group, which was lower than 21.62% in the control group(P<0.05).Conclusion: For AMI patients with heart failure, tirofiban can improve left ventricular function and myocardial reperfusion level during and after PCI, which is helpful to reduce the risk of MACE.
- tirofiban /
- furosemide /
- acute myocardial infarction /
- heart failure /
- percutaneous coronary intervention

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