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| Effect of Reteplase combined with Tirofiban for the microcirculation and coagulation function of elderly patients with acute myocardial infarction |
| XU Kai1 ZHAO Cunrui2 CHEN Rufei1 SUN Mu1 JIA Junzheng1 LIU Jia1 XING Erke1▲ |
1.Department of Cardiology, Baoji Hospital of Traditional Chinese Medicine, Shaanxi Province, Baoji 721000, China;
2.Department of Cardiology, the First Hospital of Lanzhou University, Gansu Province, Lanzhou 730000, China |
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Abstract Objective To observe the effect of Reteplase combined with Tirofiban for the microcirculation and coagulation function of elderly patients with acute myocardial infarction. Methods The data of total 120 patients with acute myocardial infarction treated in Baoji Hospital of Traditional Chinese Medicine from March 2014 to March 2016 was analyzed retrospectively, and they were divided into control group and observation group according to different therapeutic methods, with 60 cases in each group. The control group was given Reteplase by intravenous drip, the observation group was given Reteplase combined with Tirofiban by intravenous drip. The indices of microcirculation, coagulation function before and 4, 24 h after treatment and related indices of fibrinolysis before and after treatment for 4 h between the two groups were observed and compared. Results Compared with before treatment, the peak intensity (PI) of the two groups 4, 24 h after treatment was enhanced, the area under curve (AUC) was increased and the QTd was shortened, the differences were all statistically significant (P ＜ 0.05). 4, 24 h after treatment, the PI, AUC of observation group were higher than those of control group, the QTd was shorter than that of control group, the differences were all statistically significant (P ＜ 0.05). At the same time, the falling range of ST-elevation in the observation group 4, 24 h after treatment was higher than that of control group, the time to get to the enzyme peak was faster than that of control group, the differences were all statistically significant (P ＜ 0.05). Compared with before treatment, the thrombin time (TT), prothrombin time (PT), activated partial thromboplastin time (APTT) of the two groups 4, 24 h after treatment were prolonged, the contents of serum fibrinogen (FIB) in the two groups were decreased, while the contents of D-Dimer (D-D) were increased, the differences were all statistically significant (P ＜ 0.05). 4, 24 h after treatment, the TT, PT, APTT of observation group were longer than those of control group, the content of serum FIB was lower than that of control group, the content of D-D was higher than that of control group, the differences were all statistically significant (P ＜ 0.05). 4, 24 h after treatment, the levels of tissue plasminogen activator (t-PA) of the two groups were increased, while the levels of plasminogen (PLG), α2-plasmin inhibitor (α2-PI) and plasminogen activator inhibitor (PAI-1) were decreased, and the level of t-PA in observation group was higher than that of control group, the levels of PLG, α2-PI and PAI-1 were lower than those of control group, the differences were all statistically significant (P ＜ 0.05). Conclusion Reteplase combined with Tirofiban can effectively improve the coronary microcirculation and coagulation function of elderly patients with acute myocardial infarction, which is useful to improve the blood supply of ischemic myocardium, reduce myocardial damage, it is worthy of clinical promotion and application.
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