替罗非班对急性心肌梗死冠状动脉介入术后心肌保护作用机制及预后的影响

Tirofiban in Acute Myocardial Infarction after Percutaneous Coronary Intervention and Prognosis of Myocardial Protection Mechanism of Effects

目的探讨替罗非班对急性心肌梗死冠状动脉介入术后心肌保护作用机制及预后的影响。方法选择2009年1月～2011年1月在我院治疗的STEMI患者52例作为研究对象,随机分为观察组(PCI术+替罗非班)和对照组(直接进行PCI术)两组,比较两组术后血流TIMI分级及主要不良心脏事件发生率、出血发生率;两组术后LVEF及住院时间;两组治疗前后心电图改变情况。结果观察组PCI术后梗死相关血管血流TIMI分级II级及III级两组比较,差异有统计学意义(P<0.05)。观察组PCI术后4周主要不良心脏事件比较发生率明显低于对照组(P<0.05),观察组发生非大量出血的发生率明显高于对照组(P<0.05)。观察组左室LVEF较对照组明显改善,观察组ST段下降的幅度较对照组更明显,且PCI术后观察组缺血导联的个数明显少于对照组(P<0.05)。结论替罗非班应用于急性心肌梗死冠状动脉介入术后疗效确切,并发症少,对心肌具有保护作用,明显改善了STEMI患者的预后,值得推广和应用。

Objective To investigate tirofiban on percutaneous coronary intervention after acute myocardial infarction myocardial protection mechanism and prognosis. Methods All 52 patients with STEMI treated as subjects were randomly divided into two groups （ PCI surgery ＋ tirofiban ） and the control group （ direct PCI ） groups in our hospital from January 2009 to January 2011, and to compare the postoperative blood flow TIMI grade and the incidence of major adverse cardiac events, the incidence of bleeding; Postoperative LVEF and hospitalization; ECG changes before and after treatment situation. Results The blood flow in infarct-related artery after PCI TIMI grade class II and III groups, the difference was statistically significant （P 〈 0.05 ）. Study group 4 weeks after PCI compared the occurrence of major adverse cardiac events was significantly lower than the control group （P 〈 0.05 ）, massive bleeding occurring in the observation group were significantly higher （ P 〈 0.05 ）. LVEF left ventricular observation group than in the control group was improved significantly in the observation group the decrease in ST segment was more apparent than in the control group, and the PCI group were observed after ischemia was significantly less than the number of lead control group （P 〈 0.05 ）. Conclusion Tirofiban used in acute myocardial infarction after percutaneous coronary intervention efficacy, fewer complications, has a protective effect on the myocardium, significantly improved the prognosis of patients with STEMI, should be promoted and applied.