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Effects of Reteplase Combined with Bivalirudin on TIMI Blood Flow Grade and MACE Incidence after PCI for Acute Myocardial Infarction |
MA Xiao-lei, SHI Yue-fei |
Hanzhong Central Hospital,Hanzhong Shaanxi 723000 |
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Abstract 【Objective】To investigate the effects of reteplase combined with bivalirudin on the blood flow grade of myocardial infarction thrombolysis test (TIMI) and the occurrence of major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI). 【Methods】A total of 114 AMI patients who underwent PCI in our hospital was prospectively selected and randomly divided into observation group (Reteplase combined with bivalirudin) and control group (Reteplase treatment), 57 cases in each group. TIMI blood flow grade, cardiac function indexes [left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV), vascular resistance (SVR), left ventricular ejection fraction (LVEF), serum vascular endothelial function indexes nitric oxide (NO), nitric oxide synthase (NOS), endothelin (ET-1)],serum myocardial injury indexes [lactate dehydrogenase (LDH), troponin (cTNI) and creatine kinase isoenzyme (CK-MB)] were compared between the two groups. The incidence of MACE at 1 month after operation was recorded. 【Results】One week after operation, the proportion of TIMI blood flow grade 3 and LVEF level in the observation group were higher than those in the control group, and the levels of LVEDV, LVESV and SVR in the observation group were lower than those in the control group (P<0.05); One week after operation, the levels of serum LDH, cTNI, CK-MB and ET-1 in the observation group were lower than those in the control group, the levels of serum NO and NOS in the observation group were higher than those in the control group (P<0.05). The incidence of mace in the observation group one month after operation was lower than that in the control group, the difference was statistically significant (P<0.05). 【Conclusion】Reteplase combined with bivalirudin can significantly improve myocardial perfusion, cardiac function and vascular endothelial function, reduce myocardial injury and effectively reduce the incidence of MACE in patients with AMI after PCI.
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Received: 16 October 2020
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[1] 董艳丽,董淑娟.替格瑞洛片联合阿司匹林片用于经皮冠状动脉介入术的急性ST段抬高型心肌梗死患者的临床研究[J].中国临床药理学杂志,2019,35(7):16-18. [2] JUNG C, KELM M, NITSCHMANN S.PCI strategies in patients with acute myocardial infarction and cardiogenic shock:CULPRIT-SHOCK[J].Internist,2018,59(5):514-516. [3] 鲁硕,郑晓群,侯凤霞.重组人尿激酶原对治疗急性心肌梗死发生无复流患者P选择素的影响[J].中国医师进修杂志,2019,42(10):942-946. [4] 邓庆才,刘亚辉,李文平,等.半剂量瑞替普酶联合瑞舒伐他汀对急性ST段抬高型心肌梗死患者凝血状态的影响[J].医学临床研究,2018,35(6):1124-1126. [5] 廖威,章楠,詹冀.比伐卢定在老年急性心肌梗死患者急诊行经皮冠状动脉介入术中的效果[J].中华老年多器官疾病杂志,2020,19(2):127-131. [6] 汪贵忠,赵胜,许恩文,等.重组人尿激酶原冠状动脉内注射对行经皮冠状动脉介入术的急性心肌梗死患者的影响研究[J].实用心脑肺血管病杂志,2018,26(6):19-23. [7] OZAKI Y,KATAGIRI Y,ONUMA Y,et al.CVIT expert consensus document on primary percutaneous coronary intervention(PCI)for acute myocardial infarction(AMI)in 2018[J].Cardiovasc Interv Ther,2018,33(2):178-203. [8] 郭舜奇,王文亮,罗燕华,等.前列地尔对改善急性心肌梗死PCI术后无复流现象的疗效观察[J].实用医学杂志,2018,34(16):2761-2765. [9] 吴哲兵.硝普钠联合替罗非班冠状动脉内注射对急性心肌梗死急症PCI术后无复流的临床效果[J].介入放射学杂志,2019,28(2):156-158. [10] 羊子伦,羊壮绵,郑伟民,等.瑞替普酶联合替罗非班治疗老年STEMI患者的疗效及对凝血功能的影响[J].解放军医学院学报,2019,40(7):644-647. [11] 乔智力,徐彪,杨骄霞,等.冠状动脉内注射瑞替普酶对急性心肌梗死患者PCI术后的影响[J].中国老年学杂志,2017,37(5):1111-1113. [12] 陈要起,穆金兴,陈洪波,等.比伐卢定对急性心肌梗死患者冠脉介入术后预后的影响[J].海南医学,2018,29(9):21-24. [13] 康丽惠,叶小巾,康林.比伐芦定用于老年AMI患者PCI术后临床效果及安全性分析[J].医学临床研究,2018,35(8):1551-1553. [14] 韩娟萍,张卫泽,林丽霞,等.前列地尔对急性ST段抬高型心肌梗死PCI术后心肌缺血再灌注损伤的保护作用[J].疑难病杂志,2019,18(7):657-660. [15] 许嘉彬,王立波,陈伟达.急性ST段抬高型心肌梗死患者PCI术前应用尼可地尔对炎症反应和心肌损伤的影响[J].华南国防医学杂志,2018,32(1):8-11. |
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