| Objective: The purpose and significance of this experimental study is to find out the changes of platelet factor 4(PF4),fibrinogen degradation products(FDPs)and activated coagulation time(ACT)before and after tirofiban combined with emergency PCI,and to explore the correlation between these factors and coronary slow flow / no reflow phenomenon.Methods: From November 2018 to November 2019,patients who were treated at the First Affiliated Hospital of Jiamusi University were treated with STEMI for emergency PCI treatment.Based on the phenomenon of slow coronary blood flow / no reflow during the operation,they were set as the control group(There were 30 patients in the reflow group and 30 in the experimental group(slow blood flow / no reflow group),for a total of 60 patients.Intraarterial blood samples were taken 2 min after additional heparin was taken by coronary angiography.The ACT value was measured by an automatic coagulation timer,and the PF4 and FDPs values were detected by enzyme-linked immunosorbent assay.Result:(1)Comparison and analysis of general data of two groups of patients: There was no significant difference in age,gender,history of coronary heart disease,history of diabetes,history of hypertension,smoking history,blood lipid level,blood homocysteine level,etc.Significance(p> 0.05);Logistic analysis of history of coronary heart disease(OR = 13.613;95% CI: 1.207-153.543;p = 0.035),male(OR = 0.024;95% CI: 0.001-0.507;p = 0.016),crown Heart disease and men are independent risk factors;(2)Comparison of PF4 between two groups of patients: comparison within the group: control group: preoperative vs postoperative(19.28 ± 0.36 vs 17.86 ± 0.45;p = 0.000),the difference was statistically significant;experimental group: preoperative vs postoperative(20.59 ± 0.47 vs 19.37 ± 0.50;p = 0.000),the difference was statistically significant.Comparison between groups: Preoperative PF4: control group vs experimental group(19.28 ± 0.36 vs 20.59 ± 0.47;p = 0.033),the difference was statistically significant;postoperative PF4: control group vs experimental group(17.86 ± 0.45 vs 19.19)± 0.50;p = 0.030),the difference is statistically significant;(3)Comparison of FDPs between the two groups of patients: comparison within the group: control group: preoperative vs postoperative(16.77 ± 0.57 vs 18.27 ± 0.48;p = 0.000),the difference was statistically significant(P <0.05);experimental group: Preoperative vs postoperative(17.87 ± 0.37 vs 20.01 ± 0.42;p = 0.000),the difference was statistically significant.Comparison between groups: Preoperative FDPs: control group vs experimental group(16.77 ± 0.57 vs 17.87 ± 0.37;p = 0.245),the difference was not statistically significant;postoperative FDPs: control group vs experimental group(18.27 ± 0.48 vs 20.01 ± 0.42;p = 0.009),the difference is statistically significant.Logistic analysis of postoperative FDPs(OR = 76.225;95% CI: 5.348-1086.504;p = 0.001),the difference was statistically significant;(4)Comparison of blood ACT between two groups of patients: comparison within group: control group: preoperative vs postoperative ACT(345.13 ± 5.90 vs287.12 ± 4.40;p = 0.000),the difference was statistically significant;experimental group: preoperative ACT vs postoperative ACT(345.13 ± 4.71 vs 283.03 ± 4.03;p = 0.000),the difference was statistically significant.Comparison between groups: Preoperative ACT: control group vs experimental group(345.13 ± 5.90 vs 345.13 ± 4.71;p = 1.000),the difference was not statistically significant;postoperative ACT: control group vs experimental group(287.12 ± 4.40vs283.03)± 4.03;p = 0.520),the difference was not statistically significant;(5)Correlation analysis of PF4,FDPs,and ACT Pearson in the slow blood flow / no reflow group: analysis of ACT and PF4,FDPs,P> 0.05,the difference was not statistically significant,and there was no correlation between ACT and PF4,FDPs;PF4 before surgery,FDPs(r = 0.906 P <0.05),postoperative PF4,FDPs(r = 0.978 P <0.05),the difference was statistically significant,PF4,FDPs were positively correlated;PF4,FDPs difference correlation analysis(r =-0.281 P <0.05),the difference was statistically significant,and the difference between PF4 and FDPs was negatively correlated.Conclusion:1.Platelet factor 4(PF4)and fibrinogen degradation products(FDPs)were involved in the occurrence of coronary slow flow / no reflow after tirofiban combined with emergency PCI,and FDPs was positively correlated with coronary slow flow / no reflow.2.There was no correlation between the activated coagulation time(ACT)and the occurrence of coronary slow flow / no reflow phenomenon. |
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