盐酸替罗非班不同给药时间对急性ST段抬高型心肌梗死患者的疗效分析

Analysis of therapeutic effect of different administration time of tirofiban hydrochloride treatment of patients with acute ST-segment elevation myocardial infarction

目的探讨盐酸替罗非班不同给药时间对急性ST段抬高型心肌梗死患者抗栓治疗的临床治疗效果。方法选择2014年1~12月80例急性ST段抬高型心肌梗死患者,将其随机分成手术前治疗组（40例）和手术中治疗组（40例）。其中手术前治疗组患者于冠脉造影前使用盐酸替罗非班,手术中治疗组患者于冠脉介入治疗时使用盐酸替罗非班,最后将两组患者的治疗效果进行比较,观察指标包括TIMI帧数、Blush分级3级率、肌酸激酶同工酶（CKMB）峰值浓度以及术后90min ST下降幅度等。结果手术前治疗组TIMI帧数（22.3±7.9）要显著低于手术中治疗组（32.4±4.1）;术后90分钟ST段下降的幅度在手术前治疗组大于手术中治疗组;CKMB峰值浓度手术前治疗组（251.2±40.1）较手术中治疗组（364.9±57.1）显著降低;Blush分级的3级率手术前治疗组明显高于手术中治疗组。以上差异均有统计学意义（P〈0.05）。结论两组结果比较显示,急性ST段抬高型心肌梗死患者介入治疗前使用盐酸替罗非班具有显著改善冠脉血流的治疗效果,值得在临床上推广。

Objective To study the clinical treatment effect of different administration time of tirofiban hydrochloride on antithrombotic therap in patients with acute ST-segment elevation myocardial infarction. Methods 80 patients with acute ST-segment elevation myocardial infarction, who were selected from Janury to December 2014, were randomly divided into preoperative treatment group （40 cases） and intraoperative treatment group （40 cases）. Patients in preoperative treatment group were treated with tirofiban hydrochloride before coronary angiography, while patients in intraoperative treatment group were treated with coronary intervention therapy meanwhile tirofiban hydrochloride. To comparative analyze the treatment effect between the two groups, to compare the indexes of TIMI frame count, 3 grade rate of Blush classification, peak concentration of creatine kinase isoenzyme （CKMB）, postoperative 90min ST decrease amplitude and so on. Results TIMI frame count in preoperative treatment group（22.3 ± 7.9） was significantly lower than which in intraoperative treatment group（32.4 ± 4.1）, postoperative 90min ST decrease amplitude in preoperative treatment group was greater than which in intraoperative treatment group, peak concentration of CKMB in preoperative treatment group（251.2 ± 40.1） was obviously lower than which in intraoperative treatment group（364.9 ± 57.1）, 3 grade rate of Blush classification in preoperative treatment group was obviously higher than which in intraoperative treatment group, the differences were statically significant（P 〈 0.05）. Conclusion The comparison result between the two groups showed that, tirofiban hydrochloride in the treatment of patients with acute ST-segment elevation myocardial infarction before coronary intervention therapy, has significantly improved the treatment effect of coronary flow, is worthy of clinical popularization.