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替罗非班联合瑞替辅酶对食管癌合并心肌梗死患者心功能的改善研究(1)
http://www.100md.com 2019年12月15日 《中国医学创新》 2019年第35期
     【摘要】 目的:探讨替罗非班联合瑞替辅酶对食管癌合并心肌梗死患者心功能的影响。方法:选取2017年10月-2018年10月本院食管癌合并心肌梗死患者112例,按随机数字表分为对照组(n=56)和观察组(n=56)。对照组给予瑞替辅酶治疗,观察组在对照组基础上联合替罗非班治疗,治疗后1个月对患者效果进行综合评估,比较两组患者血流动力学指标、心功能情况、不良反应发生情况比较。结果:治疗后1个月,观察组肺动脉平均压(mPAP)、左房平均压(mLAP)及肺动脉平均压(mMVP)均低于治疗前与对照组(P<0.05);治疗后1个月,两组射血分数(LVEF)、左房内径(Lad)及左室舒张末径(LVDEd)均优于治疗前,观察组LVEF、Lad及LVDEd均明显优于对照组(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:将替罗非班联合瑞替辅酶用于食管癌患者合并心肌梗死治疗中,能提高患者治疗效果,有效改善血流动力学指标和心功能情况,降低不良反应发生率,值得推广应用。

    【关键词】 替罗非班 瑞替辅酶 心肌梗死 食管癌

    [Abstract] Objective: To investigate the effect of Tirofiban combined with Reteplase on cardiac function in esophageal cancer patients with myocardial infarction. Method: A total of 112 patients with esophageal cancer complicated with myocardial infarction in our hospital from October 2017 to October 2018 were selected. According to the random number table method, they were divided into control group (n=56) and observation group (n=56). The control group was treated with Reteplase. The observation group were treated with Tirofiban on the basis of the control group. 1 month after treatment,hemodynamic parameters, cardiac function and adverse reactions were compared between the two groups. Result: 1 month after treatment, mean pulmonary artery pressure (mPAP), mean left atrial pressure (mLAP) and mean pulmonary artery pressure (mMVP) in the observation group were lower than those before treatment and control group (P<0.05). 1 month after treatment, the ejection fraction (LVEF), left atrial diameter (Lad) and left ventricular end-diastolic diameter (LVDEd) of the two groups were better than those before treatment, while the LVEF, Lad and LVDEd of the observation group were significantly better than those of the control group (P<0.05). There was no significant difference in the incidence of adverse events between the two groups (P>0.05). Conclusion: Tirofiban combined with Reteplase for the treatment of esophageal cancer patients with myocardial infarction can improve the treatment effect of patients, effectively improve hemodynamic parameters and cardiac function, which is worthy of popularization and application.

    [Key words] Tirofiban Reteplase Myocardial infarction Esophageal cancer

    First-author’s address: The Central Hospital of Jiamusi City, Jiamusi 154002, China

    doi:10.3969/j.issn.1674-4985.2019.35.036

    心肌梗死是冠狀动脉闭塞,导致血流中断,造成部分心肌因严重的持久性缺血而发生局部坏死。具体表现有剧烈而较持久的胸骨后疼痛,身体发热,白细胞突然骤增,血清心肌酶活力增高及进行性心电图变化,会造成心律失常、休克或心力衰竭等[1]。所以对于此病一定要秉承早发现早治疗的原则。近年来替罗非班联合瑞替辅酶在心肌梗死中的应用效果反响很好,但是,替罗非班联合瑞替辅酶在食管癌合并心肌梗死患者中应用及有效性研究较少,因此,本文采用随机对照方法进行研究,探讨替罗非班联合瑞替辅酶对食管癌合并心肌梗死患者血流动力学的影响,现报道如下。, 百拇医药(张宏剑 翁志远 黄亚辉 姜军 张奇 程林)
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