急性前壁心肌梗死急诊PCI早期应用替罗非班的疗效观察

Effects of tirofiban via percutaneous intervention on early-stage acute anterior myocardial infarction

目的:探讨急性前壁心肌梗死患者急诊经皮冠脉介入治疗(PCI)早期应用替罗非班的疗效及安全性。方法:将2009年8月至2012年12月佛山市第二人民医院收治的188例急性前壁心肌梗死拟行急诊PCI患者随机分为观察组(早期应用组,92例)和对照组(延迟应用组,96例),比较两组PCI TIMI血流分级、血BNP、CTnI水平变化及主要不良心血管事件和出血风险等。结果:观察组初次造影病变血管TIMI血流达到Ⅲ级的比率明显高于延迟应用组(P<0.05);术后7 d血CTnI、BNP水平明显低于对照组(P<0.05);30 d不良心血管事件发生率低于对照组(P<0.05)。结论:急性前壁心肌梗死患者急诊PCI早期应用替罗非班有助于改善心肌灌注,降低早期不良心血管事件,可能有助于改善远期预后。

Objective： To investigate the efficacy and safety of tirofiban on early-stage acute anterior myocardial infarction via percutaneous coronary intervention （PCI）. Methods： We randomly allocated 188 patients with acute anterior myocardial infarction who were admitted to Foshan Second People＇ s Hospital between August 2009 and December 2012 to be treated with tirofiban therapy during early stage （observational group, n = 92 ） and in a delayed manner （ control group, n= 96）. This entailed comparison on the TIMI blood flow grading, changes in the level of cTnI, major cardiovascular adverse events and the risk of bleeding. Results： The observational group was associated with a pronouncedly higher proportion of patients with grade Ⅲ TIMI blood flow and yielded markedly lower levels of serum cTnI and brain natriuretic peptide at day 7 than control group （ all P 〈 0.05）. A significantly lower incidence of cardiovascular adverse events was noted in observational group at day 30 （ P 〈 0.05 ）. Conclusion： Administration of tirofiban at an early-stage is effective in improving the myocardial blood perfusion, reducing the early-stage cardiovascular adverse events and might improve long-term prognosis in patients with acute anterior myocardial infarction.