国产替罗非班在急性心肌梗死介入治疗中的应用分析

Application of Tirofiban in Percutaneous Coronary Intervention of Acute Myocardial Infarction

【目的】研究国产替罗非班（欣维宁）在急性ST段抬高型心肌梗死患者行急诊直接经皮冠状动脉介入治疗（PCI）的疗效及安全性。【方法】入选2011～2012年急性ST 段抬高型心肌梗死患者46例，随机分为观察组和对照组各23例，观察组患者于冠脉造影（CAG）后PCI前持续静脉给予欣维宁，并追加肝素50 U／kg静脉注射，而对照组仅追加肝素100 U／kg静脉注射；比较两组患者罪犯血管开通情况，前向血流心肌梗死溶栓治疗试验分级（TIMI）及校正的T IM L计帧数；比较治疗前后48 h检查心电图变化及不良反应。【结果】观察组TIMI 3级获得率高于对照组（87％和74％，P＜0．05），梗死的TIML计帧数（CTFC）明显低于对照组（22．5±4．6帧vs30．1±6．5帧，P＜0．05），治疗后48h检查心电图相关导联ST段回落幅度较对照组大（P＜0．05），缺血导联个数显著低于对照组（P ＜0．05），两组出血率无统计学意义（P ＞0．05）。【结论】急性心肌梗死患者急诊直接PCI术中联合应用欣维宁安全有效。

[Objective] To explore the efficacy and safety of domestic tirofiban in percutaneous coronary intervention（PCI） of patients with ST‐elevation myocardial infarction （STEMI） .[Methods] A total of 46 pa‐tients with STEMI from 2011 to 2012 were randomly divided into observation group （ n = 23） and control group（ n=23） .The observation group was given continuously intravenous injection of tirofiban after coronary angiography（CAG） and before PCI ,and additional injection of heparin 50U/kg intravenously ,while the con‐trol group was given additional injection of heparin 100 u/kg intravenously .The patency of the diseased ves‐sels ,thrombolysis of anterior blood flow myocardial infarction trial classification （TIMI） and the corrected TIML number were compared between two groups .The 48h‐electrocardiogram change and adverse reaction before and after treatment were compared .[Results]The achievement ratio of TIMI grade 3 in observation group was higher than that in control group（87% vs .74% ,P〈0 .05） .The infracted TIML number in obser‐vation group was obviously lower than that in control group [（22 .5 ± 4 .6） vs （30 .1 ± 6 .5） ,P 〈0 .05] .The falling extent of electrocardiogram‐related lead ST‐segment was obviously higher than that in control group（ P〈0 .05） .The number of ischemic lead in observation group was significantly lower than that in control （ P〈0 .05） .There was no significant difference in hemorrhage rate between two groups （ P 〉0 .05） .[Conclusion]Tirofiban for the treatment of acute myocardial infarction during emergency direct PCI is safe and effective .