静脉与经冠状动脉内注射替罗非班对急性ST段抬高型心肌梗死PCI术后的影响

Effects of intravenous and intracoronary injection of tirofiban on postoperative PCI in patients with acute ST-segment elevation myocardial infarction

目的:对比分析静脉与经冠状动脉内注射替罗非班对急性ST段抬高型心肌梗死PCI术后的影响。方法:选取2016年1月至2018年12月收治的78例行PCI术的急性ST段抬高型心肌梗死患者随机分为A组和B组。A组:冠脉造影后经冠脉注射替罗非班,B组:在冠脉造影前静脉注射替罗非班;比较两组治疗前后TIMI、TMPG血流分级,治疗后1周心功能指标,术后2hECGST段回落程度以及CTFC变化情况。结果:治疗前两组TIMI、TMPG血流分级无统计学差异(P>0.05),治疗后两组TIMI、TMPG血流分级均显著改善,且治疗后A组TIMI、TMPG血流分级优于B组。治疗后1周A组EF水平较B组显著提高,LVESD、LVEDD水平较B组显著降低;术后2hA组ECGST段回落程度优于B组,且术后CTFC帧较B组显著降低;A组心脑血管不良事件发生率为7.69%较B组的25.64%显著降低;差异均具有统计学意义(P<0.05)。结论:冠状动脉内注射替罗非班应用于行PCI术的急性ST段抬高型心肌梗死患者效果更优,抑制血小板聚集更强,提高心功能,降低心血管不良事件的发生,促进患者的恢复,值得在临床上推广。

Objective:To compare the effects of intravenous and intracoronary injection of tirofiban on postoperative PCI in patients with acute ST-segment elevation myocardial infarction.Methods:78 patients with acute ST-segment elevation myocardial infarction undergoing PCI from January 2016 to December 2018 were selected and divided into group A and group B randomly.Group A:coronary injection of tirofiban after coronary angiography.Group B:intravenous tirofiban before coronary angiography.The TIMI and TMPG blood flow grading,the cardiac function index 1 week after treatment,the degree of ECGST fall and the change of CTFC in the two groups were compared before and after treatment.Results:There was no significant difference in TIMI and TMPG blood flow grading between the two groups before treatment(P>0.05).After treatment,the TIMI and TMPG blood flow grading were significantly improved,and the TIMI and TMPG blood flow grading in Group A was better than B after treatment.The EF level of group A was significantly higher than that of group B at 1 week after treatment.The levels of LVESD and LVEDD were significantly lower than those of group B.The degree of ECGST was lower than that of group B at 2 h after operation,and the postoperative CTFC frame was significantly lower than that of group B.The incidence of cardiovascular and cerebrovascular adverse events in group A was 7.69%,which was significantly lower than that in group B(25.64%).The differences were statistically significant(P<0.05).Conclusion:Intracoronary injection of tirofiban for acute PCI Patients with ST-segment elevation myocardial infarction have better effects,inhibit platelet aggregation,improve cardiac function,reduce the incidence of cardiovascular adverse events,and promote recovery of patients.It is recommended to be clinically popularized.