| Purpose:To analyze the effect of percutaneous coronary intervention alone,percutaneous coronary intervention and tirofiban combined treatment on the level of heart fatty acid binding protein and the relationship with prognosis,so as to better guide the treatment of acute myocardial infarction.Methods:Collected clinical information of 302 patients with acute myocardial infarction who underwent coronary angiography in Shouguang people’s Hospital from December 2018 to June 2020 to show clear target vascular lesions and indications for percutaneous coronary intervention perform analysis.The study subjects were divided into three groups,namely ST-segment elevation myocardial infarction emergency group,ST-segment elevation myocardial infarction elective group and non-ST-segment elevation myocardial infarction group,ST-segment elevation myocardial infarction emergency group was randomly divided intocontrol group A(49 cases,PCI)and observation group A(53 cases,PCI combined with trofiban),ST-segment elevation myocardial infarction elective group was randomly divided intocontrol group B(48 cases,PCI)and observation group B(50 cases,PCI combined with tirofiban),non-ST-segment elevation myocardial infarction group was randomly divided intocontrol Group C(50 cases,PCI)and observation group C(52 cases,PCI combined with tirofiban).In addition to the conventional medical treatment,the patients in the six groups received percutaneous coronary intervention,and the patients in the observation group received tirofiban combined with percutaneous coronary intervention.TIMI blood flow grading and corrected TIMI frame count(CTFC)for six groups,heart-type fatty acid binding protein(H-FABP),cardiac function indicators(brain natriuretic peptide,left ventricular ejection fraction,left ventricular end-diastolic diameter),major adverse cardiovascular events,bleeding and thrombocytopenia,vascular endothelial function indicators(endothelin,vascular endothelial growth factor),inflammatory factors(interleukin-6,high-sensitivity C-reactive protein)for analysis and comparison,investigate the correlation between heart fatty acid binding protein(H-FABP)and cardiac function parameters.Results:1.The incidence rate of no reflow of observation group A,observation group B,and observation group C were 3.78%,6.00%,and 5.76% lower than the corresponding control group A,control group B,and control group C.The The incidence rate of no reflow were10.20%,8.32%,and 10.00%,respectively.(p<0.05),the difference was statistically significant.Corrected TIMI frame count(CTFC)corrected in observation groups A,B and C were lower than those in corresponding control groups A,B and C(p< 0.05),the difference was statistically significant.2.Differences in the levels of heart-shaped fatty acid binding protein in observation group A and control A,observation group B and control group B,observation group C and control group C before operation None was statistically significant(p>0.05).The levels of heart-shaped fatty acid binding protein in observation group A and control A,observation group C and control group C were all reduced at 48 hours after surgery(p<0.05),And observation group A and observation group C were lower than the corresponding control group A and control group C respectively(p<0.05),the difference was all statistically significant.The levels of heart-shaped fatty acid binding protein of observation group B and control B were increased(p<0.05),but observation group B was lower than that of control group B(p<0.001),the difference was statistically significant.3.There was no statistically significant difference in BNP,LVEF and LVEDD between observation group A and control A,observation group B and control group B,observation group C and control group C before operation(p>0.05).At the 3-month follow-up,the six groups The BNP and LVEDD of the patients decreased,and the LVEF increased,and the BNP and LVEDD of patients in observation group A,observation group B,and observation group C were lower than the corresponding control group A,control group B,and control group C,respectively LVEF were higher than the corresponding control group A,control group B and control group C(p<0.05),the difference was statistically significant.However,the improvement of BNP,LVEF and LVEDD in observation group A was more obvious than control group A(p<0.001).4.Observation group A,observation group B,and observation group C patients in 3months after surgery with angina,recurring myocardial infarction,acute heart failure,and revascularization,and the total incidence of MACE in 9.43%,6.00%,and 9.62% were all lower than the corresponding control group A.The incidence of control group B and control group C were16.32%,16.66%,18.00%(p<0.05),and the difference was statistically significant.5.In 48 hours after surgery there was no thrombocytopenia in the six groups of patients.The incidence of minor bleeding in patients in observation group A,observation group B,and observation group C were 7.55%,8.00%,and 9.61% higher than the corresponding control group A,control group B,and control group C,The incidence of that were 4.08%,4.16%,4.00%(p<0.05),and the difference was statistically significant.Observation group A,observation group B and observation group C correspond to the corresponding control group A,control group B and control Compared with group C,there was no significant difference in the incidence of minor bleeding,major bleeding and fatal bleeding(p>0.05).6.After treatment,the levels of vascular endothelial function and inflammation indexes such as ET,VEGF,IL-6 and hs-CRP of the six groups of patients were reduced,and the difference was statistically significant(p<0.05),and observation group A and observation group B The levels of vascular endothelial function and inflammation indicators such as ET,VEGF,IL-6 and hs-CRP of patients in observation group C and observation group C were lower than those of control group A,control group B,and control group C.The difference was statistically significant(p<0.05).7.The application of tirofiban during PCI in patients with AMI can reduce the level of H-FABP,H-FABP was negatively correlated with LVEF,and positively correlated with BNP and LVEDD.Conclusion:Tirofiban can reduce the occurrence of no reflow after PCI in patients with AMI,reduce major adverse cardiovascular events,and protect the cardiac function and vascular endothelial function of patients.The application of tirofiban during PCI in patients with AMI can reduce the level of H-FABP correspondently,and H-FABP has a good correlation with cardiac function parameters in patients with AMI.It can be used as an indicator for early evaluation of cardiac function. |
PDF Full Text Request