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目的观察国产替罗非班对急性心肌梗死(AMI)患者行急诊经皮冠状动脉介入术(PCI)后左室重构及近期预后的影响。方法本次研究收集了85例首次出现AMI并接受PCI术治疗的患者,随机分为对照组(常规治疗,n=40)和观察组(在常规治疗的基础上加用替罗非班,n=45)。应用心脏彩色多普勒超声技术测定第1天及第28天的左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、左室舒张末期容积指数(LVEDVI)以及左室收缩末期容积指数(LVESVI),并进行比较;同时观察术后心绞痛、心力衰竭、心源性猝死等主要不良心血管事件(MACE)及出血事件的发生情况。结果与对照组相比,观察组患者术后28 d时LVEDVI、LVESVI、LVEDD减小,LVEF明显改善,且梗死后MACE发生率下降(P均<0.05),出血比例虽增加,但差异无统计学意义(P>0.05)。结论替罗非班可以近期改善心室功能,抑制心室重构的演变,降低AMI患者的MACE事件发生率。同时,出血的风险无增加。
Objective To observe the effect of domestic tirofiban on left ventricular remodeling and immediate prognosis after acute percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI). Methods A total of 85 patients with AMI who were initially treated with PCI were enrolled in this study and were randomly divided into control group (n = 40) and observation group (n = 40 on the basis of conventional therapy plus tirofiban, n = 45). Left ventricular ejection fraction (LVEF), left ventricular end-diastolic dimension (LVEDD), left ventricular end-diastolic volume index (LVEDVI), and left ventricular end-systolic volume (LVEDVI) were measured by color Doppler sonography on day 1 and day 28 (LVESVI) were measured and compared. The incidences of major adverse cardiovascular events (MACE) and bleeding after operation such as angina pectoris, heart failure and sudden cardiac death were observed. Results Compared with the control group, the LVEDVI, LVESVI, LVEDD, LVEF and the incidence of MACE in the observation group decreased significantly after 28 days of operation (all P <0.05), while the proportion of bleeding increased, but the difference was not statistically significant Significance (P> 0.05). Conclusion Tirofiban can improve ventricular function, inhibit the evolution of ventricular remodeling and reduce the incidence of MACE in patients with AMI. At the same time, there is no increase in the risk of bleeding.