本文選題：替羅非班　切入點(diǎn)：替格瑞洛　出處：《中國(guó)老年學(xué)雜志》2017年05期 　論文類型：期刊論文

【摘要】：目的探討替格瑞洛聯(lián)合替羅非班在ST段抬高型心肌梗死(STEMI)糖尿病患者急診經(jīng)皮冠狀動(dòng)脈介入治療(PCI)術(shù)中的臨床療效和安全性。方法將186例STEMI合并2型糖尿病患者隨機(jī)分為對(duì)照組、替格瑞洛組、聯(lián)合藥物組,比較3組用藥前及用藥后24 h血小板聚集率的變化,PCI術(shù)后即刻冠脈血流TIMI分級(jí)、矯正TIMI計(jì)幀(CTFC)、心肌染色分級(jí)(MBG)、術(shù)后90 d心臟超聲指標(biāo)、主要不良心臟事件(MACE)及出血并發(fā)癥。結(jié)果用藥24 h后聯(lián)合藥物組血小板聚集率較對(duì)照組與替格瑞洛組明顯下降(P0.05);聯(lián)合藥物組即刻冠脈血流TIMI分級(jí)、CTFC、MBG較對(duì)照組、替格瑞洛組明顯改善(P均0.05);與對(duì)照組、替格瑞洛組比較,聯(lián)合藥物組術(shù)后90 d的左室射血分?jǐn)?shù)(LVEF)、心臟指數(shù)(CI)、每搏指數(shù)(SVI)增加,左室收縮末期內(nèi)徑(LVESD)、左室舒張末期內(nèi)徑(LVEDD)減少(均P0.05);聯(lián)合藥物組90 d內(nèi)主要不良心血管事件明顯減少(P0.05),出血并發(fā)癥無(wú)明顯變化(P0.05)。結(jié)論 STEMI合并糖尿病患者PCI術(shù)中聯(lián)合應(yīng)用替格瑞洛與替羅非班可明顯降低血小板聚集功能,提高即刻冠脈血流和心肌微循環(huán)水平,改善心功能,減少主要不良心血管事件的發(fā)生,且不增加出血風(fēng)險(xiǎn),具有較好的臨床療效和安全性。
[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.
【作者單位】： 武警邊防部隊(duì)總醫(yī)院心內(nèi)科;新疆醫(yī)科大學(xué)第一附屬醫(yī)院心內(nèi)科;
【基金】：國(guó)家自然科學(xué)基金項(xiàng)目(8126041) 新疆維吾爾自治區(qū)科技支疆項(xiàng)目(2013911111)
【分類號(hào)】：R542.22;R587.1

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