替罗非班用于急性心肌梗死介入治疗的疗效及安全性分析

Efficacy and safety of tirofiban in interventional therapy of acute myocardial infarction

目的 分析经皮冠状动脉介入（PCI）联合替罗非班治疗急性心肌梗死（AMI）的疗效及安全性。方法 以我院2012年7月~2014年7月收治的110例AMI患者为研究对象,按照入院顺序编号,采用随机数字表法分为对照组和观察组,各55例。两组均给予常规PCI治疗。术前均口服负荷量阿司匹林300 mg、氯吡咯雷300 mg,术后口服氯吡格雷75 mg、阿司匹林100 mg。术后皮下注射低分子肝素钙5000 U,1次/d,连续注射5~7 d。观察组行PCI术中静脉推注5μg/kg的盐酸替罗非班氯化钠注射液,之后的36 h内将剂量控制为0.15μg/（kg·min）,使用微量泵持续泵入。比较两组的疗效及安全性。结果 PCI术后,观察组TIMI分级Ⅲ级者所占比例明显高于对照组（P〈0.05）,说明观察组的疗效好。术后4 w内,观察组心血管不良事件发生率明显低于对照组（P〈0.01）;两组不良反应发生率无统计学差异（P〉0.05）。结论 替罗非班能有效降低PCI术后不良心血管事件的发生,且无严重不良反应。

Objective To explore the efficacy and safety of percutaneous coronary intervention （PCI） combined with tirofiban in the treatment of acute myocardial infarction （AMI）. Method8 A total of 110 patients with AMI admitted to our hospital from July 2012 to July 2014 were selected and randomly divided into a control group and an observation group （n=55, respectively）. The two groups were treated with conventional PCI. The two groups orally took aspirin 300 mg and clopidogrel 300 mg before the operation, and clopidogrel 75 nag and aspirin 100 mg after the operation, with subcutaneous injection of low-molecular-weight heparins calcium 5000 U （once a day, for five to seven days）. The observation group was treated with 5μg/kg tirofiban hydrochloride sodium chloride injection by intravenous injection during PCI; and then, the dosage was controlled to 0.15μg/（kg.min） within 36 h by micro pump for micro pumping. The efficacy and safety in the two groups were compared, Results Postoperative TIMI grade Ⅲ in the observation group was markedly higher than that in the control group （P 〈 0.05）, indicating that the efficacy in the observation group was better. The incidence of major adverse cardiovascular events in the observation group four weeks after the operation was significantly lower than that in the control group（P 〈 0.01）. There was no significant difference between the incidences of adverse reactions in two groups （P 〉 0.05）. Conclusion Tirofiban can effectively lower the incidence of major adverse cardiovascular events after PCI. There is no severe adverse reaction.