替罗非班联合阿司匹林、氯吡格雷、低分子肝素对老年急性非ST段抬高型心肌梗死患者左心功能及心肌再灌注的临床研究

摘要

ObjectiveInvestigate the clinical value of tiroifban combined with aspirin, clopidogrel and low molecular heparin for elderly patients with acute non ST segment elevation myocardial infarction (USTAMI). Method148 patients with USTAMI were randomly divided into observation group and control group, 74 cases in each group, observation group were given tiroifban combined with aspirin, clopidogrel and low molecular heparin treatment, control group were given aspirin, low molecular weight heparin. Compared myocardial infarction after 6 hours of creatine kinase isoenzyme (CK-MB), cardiac troponin (cTnI), CK-MB, cTnI peak time and 30 days left ventricular ejection fraction (LVEF) of two groups.ResultThe concentrations of LVEF, CK-MB and cTnI had no signiifcant difference between pre-treatment and after 30 days of treatmen (P>0.05). The concentrations of CK-MB and cTnI were signiifcant higher after 6 hours of treatment than pre-treatment, and the concentation of LVEF were signiifcantly improved after 30 days of treatment (P<0.05). And the rising rate of the concentration of CK-MB and cTnI were signiifcantly slower in observation group than that in control group (P<0.05), the increase of the concentration of LVEF was more obviously in observation group than that in control group (P<0.05), and the period to the peak concentration of CK-MB and cTnI were signiifcantly shorter than that in control group (P<0.05).ConclusionTiroifban combined with aspirin, low molecular heparin for elderly acute in patients with non ST segment elevation myocardial infarction is better than aspirin with Clopidogrel and low molecular heparin.%目的：探讨替罗非班联合阿司匹林、氯吡格雷及低分子肝素治疗老年急性非ST段抬高型心肌梗死（USTAMI）的临床价值。方法将148例USTAMI患者随机分为观察组与对照组，每组各74例，观察组患者给予替罗非班、阿司匹林、氯吡格雷及低分子肝素治疗，对照组患者给予阿司匹林、氯吡格雷、低分子肝素治疗。对比两组患者心肌梗死后6小时肌酸激酶同工酶（CK-MB）、肌钙蛋白（cTnI）改善情况，CK-MB、cTnI达峰时间及30天左室射血分数（LVEF）。结果两组患者治疗前30天LVEF、CK-MB及cTnI含量比较差异无显著性（P＞0.05）；治疗后6小时CK-MB及cTnI水平、治疗后30天LVEF均较治疗前明显升高，且观察组患者治疗后6小时CK-MB及cTnI水平升高更为缓慢，而治疗后30天LVEF增加更加明显；观察组患者CK-MB、cTnI达峰时间明显短于对照组（P＜0.05）。结论替罗非班联合阿司匹林、氯吡格雷、低分子肝素治疗老年USTAMI疗效优于单纯应用阿司匹林、氯吡格雷、低分子肝素，且药物安全性高，不良反应少，可有效缓解患者病情，提高其生活质量，值得临床推广应用。