【摘要】 目的观察替罗非班在急性心肌梗死(AMI)急诊PCI治疗中的有效性和安全性。方法 100例接受急诊PCI治疗的急性心肌梗死患者,随机分为替罗非班组(常规PCI+替罗非班,50例)和对照组(常规PCI,50例),均于发病8h内行急诊PCI术。比较两组患者PCI术前、术后梗死相关血管(IRA)血流TIMI分级情况,24h心电图ST段回落情况,10d后左室射血分数(LVEF)指标,术后30d内出血并发症及主要不良心脏事件(MACE)的发生情况。结果两组患者基础临床情况、术前造影情况差异无统计学意义(P>0.05)。替罗非班组与对照组TIMI3级血流分别为96%(48/50)和88%(44/50);替罗非班组LVEF(58%±7%)优于对照组(53%±8%);术后替罗非班组24h心电图ST段回落≥50%发生29例,对照组发生13例;出血并发症发生率两组比较;术后30d内主要不良心脏事件的发生率替罗非班组和对照组分别为8%(4/50)和16%(8/50);差异均具有统计学意义(P<0.05)。结论在AMI急诊PCI治疗中,应用替罗非班可以改善梗死相关血管的TIMI血流情况,减少不良心脏事件发生,改善患者预后,临床应用安全有效,值得推广。更多还原

【Abstract】 Objective Observation of tirofiban in patients with acute myocardial infarction(AMI) efficacy and safety of emergency treatment in PCI. Methods 100 cases of patients with acute myocardial infarction treated by emergency PCI, were randomly divided into tirofiban group(conventional PCI+ tirofiban, n=50) and control group(50 cases, conventional PCI, both in the pathogenesis of 8h) underwent emergency PCI operation. The infarct related artery in patients with PCI were compared between the two groups before and after the operation,(IRA) TIMI flow grade, 24 hour ECG ST segment, left ventricular ejection fraction 10d(LVEF) index, bleeding complications and major adverse cardiac events within 30 d after operation(MACE) occurrence condition.Results No statistical significance in patients with clinical data, two groups in preoperative contrast difference(P>0.05). The tirofiban group and control group TIMI 3 grade were 96%(48/50) and 88%(44/50); tirofiban LVEF(58%±7%) than the control group(53%±8%); postoperative tirofiban group 24 hours ECG ST segment 29 cases aged 50%, control group 13 cases of hemorrhage; complication rate between the two groups; within 30 d after operation, the incidence of major adverse cardiac events in tirofiban group and control group were 8%(4/50) and 16%(8/50); the differences were statistically significant(P<0.05).Conclusions AMI in the emergency treatment of PCI, TIMI blood flow of tirofiban can improve the infarction related artery, reduce adverse cardiac events, improve the prognosis of patients, the clinical application is safe and effective, worthy of promotion.更多还原