给药方式对替罗非班治疗急性心肌梗死患者PCI预后效果的影响

Effect of administration mode on the prognosis of PCI in patients with acute myocardial infarction

目的探讨给药方式对替罗非班治疗急性心肌梗死患者经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)预后效果的影响。方法选取急性心肌梗死患者200例,随机分为3组,经静脉组70例、经冠状动脉组70例和对照组60例。经静脉组经静脉注射10μg/kg负荷量替罗非班,经冠状动脉组给予10μg/kg负荷量替罗非班,对照组给予常规治疗。结果经静脉组、经冠状动脉组PCI术后心肌梗死溶栓治疗血流分级更偏向于分级高的2级和3级,与对照组差异有统计学意义(P<0.05);3组病死率差异无统计学意义(P>0.05);经静脉组和经冠状动脉组顽固性缺血、恶性心律失常、再次心肌梗死等主要不良心脏事件发生率均显著低于对照组(P<0.05),左心室射血分数、舒张早期心室充盈速度最大值/舒张晚期心室充盈速度最大值比值>1的比例、出血发生率均显著高于对照组(P<0.05),血小板计数均显著少于对照组(P<0.05)。结论经静脉及经冠状动脉给予负荷量替罗非班均能够有效改善急性心肌梗死患者PCI预后。

Objective To investigate the effect of coronary intervention on the prognosis of patients with acute myocardial infarction treated by percutaneous coronary intervention （PCI）. Methods Two hundred cases of patients with acute myocardial infarction were randomly selected, who were divided into three groups, namely intravenous group（n = 70）, intracoronary group （n=-70） and control group（n= 60）. The intravenous group were given intravenous bolus 10μg/kg loading dose tirofiban, the intracoronary group were given coronary 10 μg/kg loading dose tirofiban, the control group were given conventional treatment. Results The thrombolysis in myocardial infartion flow 0, 1, 2 ratios after PCI of the intravenous group, coronary group were significantly lower （P〈 0.05）, the 3 ratio was significantly higher （P〈 0.05）. There was no significant difference in mortality between the 3 groups（P〈0.05）. The incidences of the death, refractory ischemia, malignant arrhythmia, again primary endpoint of myocardial infarction in intravenous group and coronaryartery group were significantly lower than that in the control group（P〈0.05）. The Left ventricular ejection fraction, E/A〉I ratio, incidence of bleeding were significantly higher（P〈0.05）, the platelet count was significantly less than that in the control group（P〈0.05）. Conclusion Intravenous and intracoronary loading dose of tirofiban are . able to improve the PCI prognosis of patients with acute myocardial infarction.