急性心肌梗死患者介入术后使用替罗非班的疗效和安全性评价

Evaluation on the safety and efficacy of tirofiban in patients with acute myocardial infarction treated by primary percutaneous coronary intervention

目的观察急性心肌梗死患者介入治疗术后应用替罗非班的疗效和安全性。方法回顾性查阅本院2007-2008年急性心肌梗死患者病历共150份，均为发病12h内行急诊PCI术。其中对照组患者72例，替罗非班组在对照组用药基础上使用替罗非班的患者有78例，观察PCI术前、术后梗死相关血管TIMI血流情况，术后4周内并发症及主要不良事件的发生情况。结果替罗非班组和对照组无复合终点事件的发生；替罗非班组PCI术后慢复流发生率低于对照组，差异有统计学意义（P〈0．05）；替罗非班组出现不良反应的患者有24例，不良反应发生率为30．8％。对照组出现不良反应的患者共18例，不良反应发生率为25．7％，差异无统计学意义（P〉0．05）。结论应用替罗非班能改善急性心肌梗死患者PCI术后梗死相关血管的TIMI血流，不良反应发生率与对照组相似，临床应用安全有效。

Objective Evaluation on the safety and efficacy of Tirofiban in patients with acute myocardial infarction（AMI）treated by primary percutaneous coronary intervention （PCI）. Methods 150 consecutive patients with AMI were observed form 2007 to 2008. All the individuals were performed PCI within 12 hours after onset of AMI. 150 cases were divided into two groups：the control group （n = 72 ）, the test group （n = 78 ）received the same treatment as group plus Tirofiban. Thrombolysis in acute myocardial infarction（TIMI） grade was observed. The major adverse cardiac events （ MACE ） at 4 weeks and bleeding complications were studied. Resuits All the individuals of both group had no the MACE. In the test group, the occurance of slow-reflow at 4 weeks were lower than those in control group, there was significant difference in both groups. 24 cases of occurred adverse reaction in test group （ 30. 8% ）, 18 cases of occurred adverse reaction in control group （25.7%） ,there was no significant difference. Conclusion Application of Tirofiban during primary PCI in patients with AMI was safe and effective ,which may improve TIMI flow of infarction related artery in patients with AMI, occurrence of adverse cardiac events was the same as those in control group.