RESUMO
Objectives: To observe the clinical significance of N-terminal natriuretic peptide combined with inflammatory factors, oxidative stress factors and blood lipid detection in elderly patients with Type-2 diabetes complicated with CHD (CHD), and provide a theoretical basis for the diagnosis and treatment of elderly patients with Type-2 diabetes complicated with CHD. Methods: A total of 40 patients with Type-2 diabetes complicated with CHD admitted to Affiliated Hospital of Hebei University from July 2019 and July 2020 were selected as the experimental group, and 40 patients with CHD who were hospitalized in our hospital during the same period without diabetes were selected as the control group. Venous blood was taken from all patients on morning and fasting basis, and their serum inflammatory factors as well as antioxidant molecules were examined respectively. Serum inflammatory factors include serum tumor necrosis factor α (TNF-A), interleukin-6 (IL-6), and C-reactive protein. Antioxidant molecules include antioxidant molecules superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), total antioxidant capacity (TAC), catalase (CAT), glutathione reductase (GR), N-terminal natriuretic peptide (NT-proBNP), white blood cells (WBC), hemoglobin (HBG), albumin (ALB) and blood lipid levels. The differences of the above indexes between experimental group and control group were compared and analyzed. Results: The serum levels of TNF-a, CRP, and IL-6 in the experimental group were apparently higher than those in the control group, with a statistically significant difference (P=0.00); The levels of SOD, TAC and CAT in the experimental group were significantly lower than those in the control group, with a statistically significant difference (P=0.00); The level of NT-proBNP and WBC count in the experimental group were significantly higher than those in the control group, with a statistically significant difference (NT-proBNP, P=0.01; WBC, P=0.00). However, no statistically significant difference was observed in the levels of HBG and ALB between the two groups (P>0.05). The experimental group had significantly higher TC and TG levels than the control group, with statistically significant differences (TC, P=0.01; TG, P=0.02), but had a significantly lower HDL level than the control group, with a statistically significant difference (P=0.00). Conclusion: Elderly patients with Type-2 diabetes complicated with CHD showed systemic microinflammation, decreased antioxidant molecule content, as well as myocardial damage and abnormal lipid metabolism compared with patients with CHD alone. For this reason, attention should be paid to the above risk factors in clinical practice, and proactive prevention and treatment should be taken to reduce the probability of related complications.
RESUMO
OBJECTIVES: To evaluate the effect of tirofiban injection on vascular endothelial function, cardiac function, inflammatory cytokines and other indicators in patients with acute myocardial infarction after emergency PCI and its clinical significance. METHODS: Eighty patients with acute myocardial infarction admitted to Affiliated Hospital of Hebei University from March 18, 2020 to October 18, 2020 were enrolled and randomly divided into two groups: the experimental group and the control group, with 40 cases in each group. Patients in both groups underwent PCI. Patients in the control group were given oxygen inhalation, monitoring, and basic medications for myocardial infarction, such as nutritional myocardial drugs, statins, aspirin, nitrates, clopidogrel, and ß-blockers. In contrast, patients in the experimental group received tirofiban 10 ug/kg intravenously over 5min immediately before PCI in addition to basic treatment, and then tirofiban 0.1 ug/(kg/min) was pumped via intravenous pump postoperatively for 48 hour. The changes of vascular endothelial function, cardiac function and adverse drug reactions (ADRs) in the two groups before treatment, one week and one month after treatment, as well as changes of inflammatory cytokines such as CRP and IL-6 in the two groups before and after treatment were compared and analyzed. RESULTS: Compared with the control group, FMD, NO, ET-1 and other indexes in the experimental group were significantly improved one week and one month after treatment, with statistically significant differences (p<0.05). BNP, LVEDD, LVEF and additional indexes in the experimental group were significantly lower than those in the control group at one week and one month after treatment, with statistically significant differences (p=0.00). Moreover, the incidence of ST-segment fallback > 70% in the experimental group was 72.5% after treatment, which was significantly better than that of 47.5% in the control group, with a statistically significant difference (p=0.03). CRP and IL-6 in the experimental group were significantly lower than those in the control group after treatment, with a statistically significant difference (p=0.00). There was no statistical significance in the incidence of ADRs between the two groups after treatment (p=0.42). CONCLUSION: Tirofiban injection after emergency PCI is a beneficial treatment regime for patients with STEMI. With such a treatment regime, cardiac function and vascular endothelial function of patients can be dramatically improved, coronary blood supply will be ameliorated, inflammatory cytokines can be reduced, and no significant increase can be seen in the incidence of adverse reactions.
