[1]栾　一,杨吉操.美托洛尔联合西洛他唑在急性心肌梗死患者经皮冠状动脉介入术后的应用价值[J].新乡医学院学报,2021,38(7):619-623.[doi:10.7683/xxyxyxb.2021.07.004]
　LUAN Yi,YANG Jicao.Application value of metoprolol combined with cilostazol in patients with acute myocardial infarction after percutaneous coronary intervention[J].Journal of Xinxiang Medical University,2021,38(7):619-623.[doi:10.7683/xxyxyxb.2021.07.004]
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美托洛尔联合西洛他唑在急性心肌梗死患者经皮冠状动脉介入术后的应用价值
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
38
期数:
2021年7
页码:
619-623
栏目:
临床研究
出版日期:
2021-07-05

文章信息/Info

Title:
Application value of metoprolol combined with cilostazol in patients with acute myocardial infarction after percutaneous coronary intervention
作者:
栾　一; 杨吉操
（南阳市第二人民医院心血管内科，河南　南阳　473000）
Author(s):
LUAN Yi; YANG Jicao
(Department of Cardiovascular Medicine,Nanyang Second General Hospital,Nanyang 473000,Henan Province,China)
关键词:
急性心肌梗死; 经皮冠状动脉介入术; 美托洛尔; 西洛他唑; 肌酸激酶; 心型脂肪酸结合蛋白; 血流动力学; 心功能
Keywords:
acute myocardial infarction; percutaneous coronary intervention; metoprolol; cilostazol; creatine kinase; heart muscle fatty acid-binding protein; hemodynamics; cardiac function
分类号:
R541.4
DOI:
10.7683/xxyxyxb.2021.07.004
文献标志码:
A
摘要:
目的　探讨美托洛尔联合西洛他唑在急性心肌梗死（AMI）患者经皮冠状动脉介入术（PCI）后的应用价值。方法　选择2017年1月至2019年4月南阳市第二人民医院收治的216例AMI患者为研究对象，所有患者行PCI治疗，根据术后治疗方法将患者分为观察组和对照组，每组108例。对照组患者PCI后给予美托洛尔治疗，观察组患者PCI后给予美托洛尔和西洛他唑联合治疗，2组患者均治疗1个月。2组患者药物治疗1个月后评估临床疗效；对2组患者治疗前和治疗后心功能指标左心室射血分数（LVEF）、心脏指数（CI）、每搏输出量（SV）及血流动力学指标平均左心房压（mLAP）、平均肺动脉压（mPAP）、平均二尖瓣压力差（mMVP）和血清肌酸激酶（CK）、心型脂肪酸结合蛋白（h-FABP）水平进行比较，并观察治疗期间2组患者不良反应发生情况；2组患者术后随访6个月，观察主要不良心血管事件发生情况。结果　观察组和对照组患者治疗总有效率分别为91.67%（99/108）、79.63%（86/108），观察组患者治疗总有效率显著高于对照组（χ2=6.365，P＜0.05）。治疗前2组患者SV、LVEF、CI比较差异无统计学意义（P＞0.05），2组患者治疗后SV、LVEF、CI显著高于治疗前（P＜0.05）；治疗后，观察组患者SV、LVEF、CI显著高于对照组（P＜0.05）。治疗前2组患者mLAP、mPAP、mMVP比较差异无统计学意义（P＞0.05），2组患者治疗后mLAP、mPAP、mMVP显著低于治疗前（P＜0.05）；治疗后，观察组患者mLAP、mPAP、mMVP显著低于对照组（P＜0.05）。治疗前2组患者血清CK、h-FABP水平比较差异无统计学意义（P＞0.05），2组患者治疗后血清CK、h-FABP水平显著低于治疗前（P＜0.05）；治疗后，观察组患者血清CK、h-FABP水平显著低于对照组（P＜0.05）。治疗期间，观察组和对照组患者不良反应发生率分别为7.41%（8/108）、6.48%（7/108），2组患者不良反应发生率比较差异无统计学意义（χ2=0.072，P＞0.05）。术后6个月，观察组患者脱落5例，对照组患者脱落2例；2组患者心力衰竭、心源性休克、严重心律失常、再发心绞痛的发生率比较差异无统计学意义（P＞0.05）。结论　美托洛尔联合西洛他唑可以显著改善PCI后AMI患者的血流动力学和心肌损害，提高患者心功能。
Abstract:
Objective　To investigate the application value of metoprolol combined with cilostazol in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI).Methods　A total of 216 patients with AMI admitted to Nanyang Second General Hospital from January 2017 to April 2019 were selected as the research subjects.All patients were treated with PCI,and they were divided into observation group and control group according to the postoperative treatment methods,with 108 cases in each group.The patients in the control group were treated with metoprolol after PCI,and the patients in the observation group were treated with metoprolol and cilostazol after PCI.All patients were treated for one month.The clinical efficacy of the patients in the two groups was evaluated after one month of drug treatment.The left ventricular ejection fraction (LVEF),cardiac index (CI),stroke volume (SV),mean left atrial pressure (mLAP),mean pulmonary artery pressure (mPAP),mean mitral valve pressure difference (mMVP) and serum creatine kinase (CK) and heart muscle fatty acid-binding protein (h-FABP) levels were compared between the two groups before and after treatment.The adverse reactions of the patients in the two groups were observed during the treatment.The patients in the two groups were followed up for six months to observe the occurrence of major adverse cardiovascular events.Results　The total effective rate in the observation group and the control group was 91.67% (99/108) and 79.63% (86/108),respectively.The total effective rate in the observation group was significantly higher than that in the control group( χ2=6.365,P＜0.05).There was no significant difference in the SV,LVEF and CI between the two groups before treatment (P>0.05).The SV,LVEF and CI after treatment were significantly higher than those before treatment in the two groups (P＜0.05).The SV,LVEF and CI in the observation group were significantly higher than those in the control group after treatment (P＜0.05).There was no significant difference in the mLAP,mPAP and MVP between the two groups before treatment (P>0.05).The mLAP,mPAP and MVP after treatment were significantly lower than those before treatment in the two groups (P＜0.05).The mLAP,mPAP and MVP in the observation group were significantly lower than those in the control group after treatment (P＜0.05).There was no significant difference in serum CK and h-FABP levels between the two groups before treatment (P>0.05).The levels of serum CK and h-FABP after treatment were significantly lower than those before treatment in the two groups (P＜0.05).The levels of serum CK and h-FABP in the observation group were significantly lower than those in the control group after treatment (P＜0.05).During the treatment,the incidence of adverse reactions in the observation group and the control group was 7.41% (8/108) and 6.48% (7/108),respectively.There was no significant difference in the incidence of adverse reactions between the two groups(χ2=0.072,P＞0.05).Six months after operation,5 patients in the observation group and 2 patients in the control group were lost to follow-up.There was no significant difference in the incidences of heart failure,cardiogenic shock,severe arrhythmia and angina pectoris reappearance between the two groups (P>0.05).Conclusion　Metoprolol combined with cilostazol can significantly improve the hemodynamics,myocardial damage and heart function in patients with AMI after PCI.

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更新日期/Last Update: 2021-07-05