|
|
|
| Effect of Tirofiban combined with thrombolytic therapy of Reteplase on the changes of cardiac parameters, levels of serum factors in elderly patients with ST-elevation myocardial infarction |
| GUO Jiaru GUO Shougui |
| Department of Cadre Ward, PLA 175th Hospital the Affiliated Dongnan Hospital of Xiamen University, Fujian Province, Zhangzhou 363000, China |
|
|
|
Abstract Objective To discuss the effects of Tirofiban combined with thrombolytic therapy of Reteplase on the changes of cardiac parameters, levels of serum factors in elderly patients with ST-elevation myocardial infarction. Methods One hundred and six cases of elderly patients with ST-elevation myocardial infarction treated in PLA 175th Hospital from December 2013 to March 2016 were selected and divided into study group and control group according to the random digital table method, with 53 patients in each group. The control group was given thrombolytic therapy of Reteplase, while the study group was given Tirofiban combined with thrombolytic therapy of Reteplase. The changes of cardiac parameters such as left ventricular end systolic diameter (LVESD), left ventricular diastolic end diastolic diameter (LVEDD), left ventricular shoot ejection fraction (LVEF), stroke volume (SV) in the two groups were observed, as well as the serum high sensitive C reactive protein (hs-CRP), homocysteine (Hcy) and complement 3 (C3) levels and the incidence rate of complications. Results There were no significant differences in the levels of SV, LVEDD, LVESD and LVEF between the two groups before treatment (P ＞ 0.05). The LVEDD and LVESD in the two groups after treatment were significantly decreased compared with those before treatment, which in the study group after treatment were significantly lower than those in the control group (P ＜ 0.05). The levels of SV and LVEF in the two groups after treatment were significantly increased compared with those before treatment (P ＜ 0.05), which in the study group after treatment were significantly higher than those in the control group (P ＜ 0.05). There were no significant differences in the levels of hs-CRP, Hcy, and C3 between the two groups before treatment (P ＞ 0.05). The levels of hs-CRP, Hcy, C3 in the two groups after treatment were significantly decreased compared with those before treatment, which in the study group were significantly lower than those in the control group (P ＜ 0.05). The incidence rate of complications in the study group was 9.43%, which was significantly lower than that in the control group (43.40%) (P ＜ 0.05). Conclusion The application of Tirofiban combined with thrombolytic therapy of Reteplase can effectively improve the heart function, decrease the levels of hs-CRP, Hcy, C3 and reduce complications.
|
|
|
|
|
|
[1] Haraki T，Uemura R，Masuda S，et al. Progressed multivessel spontaneous coronary artery dissection that naturally healed in a male patient with non-ST segment elevation myocardial infarction [J]. Case Rep Cardiol，2016，41（9）：496.
[2] 王德宇，陈海荣.瑞替普酶介入溶栓治疗下肢深静脉血栓形成疗效分析[J].中国生化药物杂志，2012，33（3）：298-300.
[3] 戴树人，李芝峰，廖荣宏，等.替罗非班联合瑞替普酶在ST段抬高性急性心肌梗死中的疗效观察[J].重庆医学，2014，43（21）：2720-2721，2724.
[4] 李福涛，王助衡，王晶锐，等.替罗非班对高危非ST段抬高型急性冠脉综合征的疗效评价[J].岭南心血管病杂志，2014，20（4）：421-424.
[5] 中华医学会心血管病学分会，中华心血管病杂志编辑委员会.急性ST段抬高型心肌梗死诊断和治疗指南[J].中华心血管疾病杂志，2010，38（8）：675-690.
[6] 彭丽华.瑞替普酶与尿激酶治疗急性ST段抬高型心肌梗死的临床观察[J].中国医药导报，2011，8（27）：55-56.
[7] Ojeda-Pena AC，Amador-Licona N，Rodríguez-Salazar E，et al. Comparison of epicardial fat thickness in diabetic patients compared to non-diabetics with acute myocardial infarction and ST-segment elevation（AMI-STEMI）[J]. Gac Med Mex，2016，152（3）：345-349.
[8] 李云.常规剂量替罗非班联合半剂量瑞替普酶治疗ST段抬高性急性心肌梗死的疗效观察[J].实用临床医药杂志，2016，20（1）：20-22.
[9] 石根萍.瑞替普酶联合低分子肝素治疗ST段抬高型急性心肌梗死的临床研究[J].中国全科医学，2010，13（19）：2109-2110.
[10] 宋锦文，王志宏，王新林，等.导管碎栓联合局部灌注瑞替普酶溶栓治疗高危肺动脉栓塞[J].介入放射学杂志，2014，23（10）：870-873.
[11] 丁永英，金汉生.瑞替普酶与尿激酶对下肢深静脉血栓治疗效果的比较[J].中国医院药学杂志，2012，32（17）：1384-1386，1414.
[12] 李道佩，黎宝妹，陈运辉.瑞替普酶联合低分子肝素钠治疗早期急性脑梗死[J].中国药房，2010，21（24）：2237-2239.
[13] 隋守光，王世礼，孙鹏，等.瑞替普酶、尿激酶经导管溶栓治疗急性下肢深静脉血栓的疗效观察[J].介入放射学杂志，2013，22（1）：57-60.
[14] 田野，张陈匀，吴曼，等.瑞替普酶在急性心肌梗死患者溶栓治疗中的疗效与安全性[J].中国老年学杂志，2015， 35（9）：2535-2536.
[15] 王会洪，马燕妮，马志强.替罗非班用于急性冠脉综合征的疗效及安全性[J].中国生化药物杂志，2012，33（1）：67-69.
[16] 冯姗.盐酸替罗非班治疗急性冠综合征的安全性和有效性评价[J].中国医药导报，2013，10（9）：81-82.
[17] 王东海，李丽蓉.替罗非班在老年非ST段抬高急性冠状动脉综合征介入治疗中的临床研究[J].中国实用医刊，2016，43（9）：112-114.
[18] 许军国.瑞替普酶联合还原型谷胱甘肽治疗急性ST段抬高型心肌梗死临床分析[J].现代医院，2015，15（5）：47-49.
[19] 田红岸，赵卫，易根发.动脉灌注替罗非班在处理颅内动脉瘤栓塞术中急性血栓栓塞的研究[J].介入放射学杂志，2012，21（9）：718-721.
[20] 孟亚锋，范春雨，刘锦.盐酸替罗非班治疗非ST段抬高型ACS的系统评价[J].中西医结合心脑血管病杂志，2016，14（11）：1266-1269.
[21] 华永平，邓婷婷，卢婷，等.瑞替普酶与尿激酶治疗急性心肌梗死的临床对比研究[J].中国现代医生，2016，54（13）：101-104.
[22] 卞秋武，王乐，王雪青，等.替罗非班联合瑞替普酶治疗急性心肌梗死安全性研究[J].中国新药杂志，2013，22（13）：1552-1555. |
|
|
|
