急性心肌梗死介入治疗前应用替罗非班的有效性与安全性观察

The Efficacy and Security of Applying Tirofiban in Patients with Acute Myocardial Infarction Before Percutancous Coronary Intervention

目的:观察急性心肌梗死介入治疗前静脉泵入替罗非班的有效性与安全性。方法:137例急性心肌梗死患者随机分为两组,治疗组68例,对照组69例,均为无条件行急诊PCI的急性心肌梗死患者。治疗组在术前持续静脉泵入替罗非班24～72小时,术前、术后应用阿司匹林300mg/天,氯吡格雷75mg/天、术前总量≥600mg,低分子肝素钙5 000U皮下注射1次/12小时,ACEI、β受体阻断剂、他汀类调脂药物,对照组除不用替罗非班外,余治疗同治疗组。观察PCI术中、术后TIMI血流,术中无复流现象发生率,术后30天内出现出血和主要心血管不良事件的发生情况。结果:替罗非班能够有效改善心肌再灌注,改善TIMI血流,减少术后无复流现象发生,不增加出血和主要心血管不良事件的发生,疗效优于常规治疗,术后30天出血和主要心血管不良事件发生无显著差异。结论:急性心肌梗死患者术前应用替罗非班安全有效。

Objecrive：To evaluate the efficacy and security of pumping intravenously tirofiban in patients with acute myocardial infarction before percutancous coronary intervention（PCI）.Methods：137 patients diagnosed AMI were randomly divided into study group（n=68） and the control group（n=69）,and all of them had do chances to operate emergency PCI.The study group were intravenously pumped tirofiban for 24～72 hours before PCI.subcutaneous injected nadroparin calcium 5000U per 12 hours,and administered aspirin（300mg qd）,clopidogrel（75mg qd and total of which before PCI≥600mg）,AECI,βreceptor antagoiiist.and statins.The therapy of control group were same as study group except the application of tirofiban.Observed the thrombolysis in myoxardial infarction{TIMI） flow during and after PCI,the rate of appearing no-reflow phenomenon during PCI,hemorrhage and main angiocarpy adverse events in 30 days after PCI.Results：Tirofiban can effectively improve myocardial perfusion and TIMI flow,reduce the rate of appearing no-reflow phenomenon,but do not increase the rate of hemorrhage and main angiocarpy adverse events.Treatment effect is better than conventional therapy,and there is no significant difference in hemorrhage and main angiocarpy adverse events in 30 days after PCI between them. Conclusion：The application of tirofiban in AMI patients before PCI is secure and effective.