替罗非班联合多巴酚丁胺治疗急性心肌梗死伴心衰患者的临床疗效观察

目的：探讨替罗非班联合多巴酚丁胺对急性心肌梗死（ AMI）患者并发心力衰竭的临床疗效。方法选择于我院就诊的未接受溶栓或急诊PCI治疗的急性心肌梗死并发心力衰竭的患者117例，随机分为对照组（ A组）、多巴酚丁胺组（ B组）、替罗非班组（ C组）和替罗非班联合多巴酚丁胺组（ D组）。检测治疗前后血中B型钠尿肽（ brain natriuretic peptide ， BNP）水平和记录超声心动图左室射血分数（ left ventricular ejection fraction ，LVEF）的变化并记录住院一周患者存活率。结果四组患者治疗前BNP、LVEF比较无统计学差异（P＞0.05），治疗后差异有统计学意义，D组患者治疗后血BNP水平低于B组、C组和A组（P＜0.05），LVEF及存活率高于B组、C组和A组（P＜0.05），B、C组治疗后血BNP水平及LVEF、存活率分别低于和高于A组（ P＜0.05）。结论替罗非班联合多巴酚丁胺对未行溶栓或急诊PCI治疗的AMI并发心衰的患者有较大的应用价值。

The application of tirofiban combined dobutamine in patients with acute myocardial infarction complicating heart failure

Objective To evaluate whether the Application of Tirofiban combined dobutamine （ Dob） is reasonable for Patients with Acute myocardial infarction （ AMI） complicating heart failure.Methods The patients with AMI complicating heart failure who did not undergo thrombolytic therapy or emergency PCI were randomly allocated into control group （ A group） ,dobutamine group （ B group）,tirofiban group（C group） and Tirofiban Combined dobutamine group （D group）. The BNP activity and LVEF were meas-ured oncome and after treatment.At the same time we recorded the survival rate after a -week treatment.Results The BNP activity and LVEF were not significant difference before treatment among the four groups （ P〉0.05 ）. The BNP activity of D group after treatment was lower than the other three groups （ P〈0.05 ） , but the LVEF and the survival rate were higher than the others.The BNP activity of B and C groups after treatment was lower than A group （P〈0.05）, the LVEF and the survival rate were higher than A group（P〈0.05）. Conclusion The application of Tirofiban Combined dobutamine has some clinical value for Patients with A -cute Myocardial Infarction complicating heart failure who do not undergo thrombolytic therapy or emergency PCI .