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替罗非班联合替格瑞洛和阿司匹林治疗经皮冠状动脉介入治疗急性心肌梗死的临床疗效及其对患者心功能的影响。

The Clinical Efficacy of Tirofiban Combined with Ticagrelor and Aspirin in Treating Acute Myocardial Infarction by Percutaneous Coronary Intervention and Its Effect on Patients' Cardiac Function.

机构信息

Department of Heart Center, The First Hospital of LanZhou University, LanZhou 730000, Gansu, China.

Department of Internal Medicine-Cardiovascular, Xiang'an Branch, The First Affiliated Hospital of Xiamen University, Xiamen 361101, Fujian, China.

出版信息

J Healthc Eng. 2022 Feb 9;2022:4708572. doi: 10.1155/2022/4708572. eCollection 2022.

Abstract

OBJECTIVE

To explore the clinical efficacy of tirofiban combined with ticagrelor and aspirin in acute myocardial infarction treatment by percutaneous coronary intervention and its effect on patients' cardiac function.

METHODS

We selected 102 patients with acute myocardial infarction who came to The First Hospital of LanZhou University for treatment from July 2018 to May 2021. On the basis of conventional treatment, patients were separated into a joint group (tirofiban combined with ticagrelor and aspirin) comprising 55 cases and a control group (conventional ticagrelor and aspirin dual treatment) involving 47 cases. Blood flow classification of the two groups of patients was immediately recorded and compared after the myocardial infarction thrombolysis test (TIMI). Left ventricular function-related indicators, platelet-related parameters, neutrophil/lymphocyte ratio (NLR), red blood cell distribution width (RDW), and platelet/lymphocyte ratio (PLR) before treatment and 7 days after PCI were evaluated and compared between the groups before treatment and 3 months after treatment. ELISA was utilized to detect the serum levels of inflammatory factors, tumor necrosis factor- (TNF-), interleukin-6 (IL-6), and hypersensitive C-reactive protein (hs-CRP) before and after treatment. Incidence of major adverse cardiovascular events (MACEs) and adverse reaction incidence was put into comparison between the two groups in the course of the 3-month follow-up period. Compared with the control group, the joint group accounted for more patients with TIMI blood flow classification level 3 ( < 0.05) and showed more drastic improvement on the left ventricular function, platelet-related parameters, and serum inflammatory factors ( < 0.05). Moreover, patients of the joint group suffered less fluctuation from RDW, NLR, and PLR ( < 0.05), and their incidence of MACE was drastically lower in contrast with the control group ( < 0.05). No notable changes were presented in terms of incidence of adverse reaction ( > 0.05). For patients who suffered from acute myocardial infarction and treated with percutaneous coronary intervention, the application of tirofiban combined with ticagrelor and aspirin could effectively reduce the incidence of no reflow or slow blood flow, improve myocardial perfusion function, and have marked curative effects. It is worthy of clinical promotion and application.

摘要

目的

探讨替罗非班联合替格瑞洛和阿司匹林在急性心肌梗死经皮冠状动脉介入治疗中的临床疗效及其对患者心功能的影响。

方法

选取 2018 年 7 月至 2021 年 5 月兰州大学第一医院收治的 102 例急性心肌梗死患者,在常规治疗的基础上,将患者分为联合组(替罗非班联合替格瑞洛和阿司匹林)55 例和对照组(常规替格瑞洛和阿司匹林双联治疗)47 例。两组患者在心肌梗死溶栓试验(TIMI)后立即记录血流分级并进行比较。比较两组患者治疗前及 PCI 后 7d 的左心室功能相关指标、血小板相关参数、中性粒细胞/淋巴细胞比值(NLR)、红细胞分布宽度(RDW)、血小板/淋巴细胞比值(PLR),并比较两组患者治疗前及治疗后 3 个月的血清炎症因子肿瘤坏死因子-(TNF-)、白细胞介素-6(IL-6)、超敏 C 反应蛋白(hs-CRP)水平。比较两组患者 3 个月随访期间主要不良心血管事件(MACEs)发生率及不良反应发生率。与对照组比较,联合组 TIMI 血流分级 3 级患者比例更高(<0.05),左心室功能、血小板相关参数及血清炎症因子改善更明显(<0.05)。而且,联合组患者 RDW、NLR、PLR 波动较小(<0.05),MACE 发生率明显低于对照组(<0.05),不良反应发生率差异无统计学意义(>0.05)。

结论

对于急性心肌梗死患者行经皮冠状动脉介入治疗,应用替罗非班联合替格瑞洛和阿司匹林可有效降低无复流或慢血流的发生率,改善心肌灌注功能,疗效显著,值得临床推广应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75eb/8849904/29bf4f3ab816/JHE2022-4708572.001.jpg

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