替罗非班在急性心肌梗死介入治疗中的临床研究

Efficacy and safety of tirofiban for percutancous coronary intervention in patients with acute myocardial infarction

目的:观察在急性心肌梗死(AMI)患者经皮行冠状动脉介入治疗(PCI)时替罗非班的有效性及安全性。方法:60例已确诊的AMI患者PCI术前随机分为替罗非班组(替罗非班+PCI,30例)和对照组(常规PCI,30例)。替罗非班组PCI术静脉应用替罗非班+半量肝素,对照组仅应用全量肝素治疗,观察两组PCI术后即刻梗死相关动脉(I-RA)TMP(TIMI myocardial perfusion)血流情况,24h及30d主要不良心脏事件(MACE)发生率,出血事件发生率。结果:替罗非班组TMP3级为96.7%(29/30),对照组为80.0%(24/30)(P<0.05),主要不良心脏事件发生率替罗非班组6.7%(2/30),对照组16.7%(5/30)(P<0.05),出血事件发生率无统计学意义(P>0.05)。结论:替罗非班可安全用于急性心肌梗死介入治疗中,改善心肌组织再灌注,减少不良心脏事件,疗效优于常规治疗。

Objective：To evaluate the efficacy and safety of tirofiban for percutaneous coronary intervention in patients with acute myocardial infarction. Methods： 60 patients diagnosed AMI were randomly divided into tirofiban group （n=30） who received tirofiban and half-heparin dose, and the control group （n=30）,who were treated by full dose heparin during PCI. The coronary TMP flow of IRA after PCI,major adverse cardiac events （MACE） rates within 24 hours and 30 days, bleeding rates were analyzed and compared between the two groups. Results：Three degree TIMI myocardial perfusion of tirofiban group was 96.7%（29/30）,but the control group was 80.0%（24/30）（P〈0.05）. The MACE rate of tirofiban group was 6.7%（2/30）,but the control group was 16.7%（5/30）（P〈0.05）. There were no difference of complication of bleeding between the two groups.Conclusion：The results suggest that tirofiban is a safe and more efficacious therapy for the patients with AMI during PCI compared with conventional therapy, which can improve the situation of myocardial reperfusion and degree the MACE.