替若非班对急性ST段抬高型心肌梗死高危患者急诊介入术后治疗的临床研究

Clinic Research of Emergency Call Intervention after Treatment for Tirofiban on Acute STEMI Patients

目的在常规抗凝、抗血小板聚集基础上,观察国产血小板膜糖蛋白Ⅱb/Ⅲa受体拮抗剂替若非班治疗急性ST段抬高型心肌梗死高危患者的疗效和安全性。方法符合急性ST段抬高型心肌梗死高危患者入选标准患者34例,按就诊顺序双盲随机分为试验组(替若非班,n=16)和对照组(n=18)。在急诊PCI术后,均使用阿司匹林,氯吡格雷和肝素的基础上,试验组给予替若非班负荷量10μg/kg,在3min内推注,继以0.15μg/kg/min由微泵持续泵入24～36h,对照组未用替若非班。结果试验组30d内主要不良心脏事件(MACE,包括顽固性心绞痛/新发心肌梗死/死亡)发生率较对照组显著降低,心电图缺血导联数明显减少,围手术期出血并发症较对照组稍高,但无统计学意义。两组术后血小板计数、心功能(射血分数值)差异无统计学意义。结论国产替若非班在急性ST段抬高型心肌梗死高危患者急诊介入治疗标准治疗基础上能进一步减少心肌缺血事件发生率,改善心电图心肌缺血改变,安全性好,但长期疗效及毒副作用有待进一步观察。

Objective Toinvestigate the efficacy and salty of tirofiban on acute STEMI patients.Method 34 patients with STEMI are randomly divided into two groups:the tirofiban +PCI group (n=16) and the primary PCI group (n=18).Tirofiban was predominantly initiated in the catheter laboratory before or during the intervention and maintained for a mean of 30h (10 μg/kg for bolus,followed by 0.15μg/kg/min infusion.Results The incidence of the major primary end point (refractory ischemis,new myocardial infarction and death...