替罗非班在治疗ST段抬高急性心肌梗死冠状动脉再通术中的应用价值分析

Analysis of the application value of tirofiban in treatment of ST-ST-segment elevation acute myocardial infarction after coronary recanalization

目的探讨替罗非班在治疗ST段抬高急性心肌梗死(AMI)冠状动脉再通术中的应用价值。方法选择2011年1月～2012年3月急诊有记录病例的ST段抬高AMI患者88例,随机分为治疗组与对照组,每组44例;2组患者治疗前均口服阿司匹林100 mg、氯吡格雷300 mg,治疗组静脉滴注盐酸替罗非班后直接PCI治疗,对照组行PCI治疗。对冠状动脉造影资料进行分析,比较2组患者TIMI血流分级、心电图ST段得恢复情况以及左室射血分数。结果治疗组与对照组的临床治疗比较差异无统计学意义(P>0.05);治疗组TIMI血流分级与对照组比较差异有统计学意义(P<0.05);心电图ST段完全回落数、左室射血分数值显著高于对照组(P<0.05)。结论应用GPIIb/IIIa受体拮抗药替罗非班治疗急性ST段抬高型心肌梗死的梗死后冠状动脉再通术患者,显著改善了冠状动脉血流和梗死区域的心肌再灌注,改善了心室的功能,预后较好,是一种安全有效的再通手段。

Objective To explore the application of value for tirofiban in the treatment of ST-segment elevation acute myocardial infarction（AMI） after coronary artery recanalization.Methods All 88 cases of ST-segment elevation AMI patients with recorded cases from January 2011 to March 2012 in the emergency department were randomly divided into the treatment group and the control group（n=44 cases for each）.The two groups were all taken with oral 100mg aspirin and 300 mg clopidogrel before treatment.The treatment group was treated with percutaneous coronary intervention after intravenous hydrochloride tirofiban.The control group was taken with PCI.The coronary angiographic data were taken for analysis.The TIMI flow grade,recovery and left ventricular ejection fraction of ST segment of ECG for the two groups were compared.Results The clinical treatment of the treatment group and control group showed no significant difference（P〉0.05）.There was statistical difference in TIMI flow grade between treatment group and control（P〈0.05）.The ST segment completely down the number of left ventricular ejection fraction value was significantly higher（P〈0.05）.Conclusion The application of GPIIb/IIIa receptor antagonist for the tirofiban in the treatment of acute ST-segment elevation myocardial infarction after coronary recanalization in patients shows significant improvement in coronary blood flow and infarction regional myocardial reperfusion,and has improved ventricular features;it has a better prognosis,and is a safe and effective means of recanalization.