替罗非班冠状动脉给药对急性ST段抬高型心肌梗死患者介入治疗效果的影响研究

Influences of intracoronary administration of tirofiban on the therapeutic effects of interventional therapy on acute ST segment elevation myocardial infarction

目的探讨替罗非班冠状动脉给药对急性ST段抬高型心肌梗死患者介入治疗效果的影响。方法选择急性ST段抬高型心肌梗死患者73例,随机分为观察组和对照组。2组以不同剂量给予替罗非班。观察组术前先经静脉给予20μg/kg替罗非班,再以0.225μg·kg^(-1)·min^(-1)的速度持续静脉泵入;对照组术前先经静脉给予10μg/kg替罗非班,再以0.150μg·kg^(-1)·min^(-1)的速度持续静脉泵入,对比2组的临床效果。结果观察组TIMI 3级占87.50%高于对照组治疗后TIMI 3级占69.70%,差异有统计学意义(P<0.05)。术后观察组LVEF高于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为15.00%(6/40),对照组的并发症发生率为9.09%(3/33),差异无统计学意义(P>0.05);观察组不良心脏事件发生率为5.00%(2/40),对照组不良心脏事件发生率为27.27%(9/33),观察组低于对照组,差异有统计学意义(P<0.05)。结论较高剂量的替罗非班可显著改善急性ST段抬高型心肌梗死患者心肌血流灌注情况,明显降低术后不良事件的发生率,具有较高的可行性和实用性。

Objective To investigate the influences of intracoronary administration of tirofiban on the therapeutic effects of interventional therapy on acute ST segment elevation myocardial infarction .Methods Seventy-three patients with acute ST segment elevation myocardial infarction were randomly divided into observation group and control group .The patients in observation group were given intravenously tirofiban 20μg/kg before operation , then given tirofiban at the speed of 0.225μg· kg^-1 · min^-1 by continuous intravenous infusion ,however,the patients in control group were given intravenously tirofiban 10μg/kg before operation,then given tirofiban at the speed of 0.150μg· kg^-1 · min^-1 by continuous intravenous infusion.The therapeutic effects were observed and compared between two groups .Results The proportion of patients with TIMI grade 3 was 87.50%in observation group ,which was significantly higher than that （69.70%） in control group （ P 〈0.05）.After operation ,the LVEF in observation group was significantly higher than that in control group （ P 〈0.05）. The incidence rate of complications in observation group was 15.00%（6/40）,which was 9.09%（3/33） in control group,there was no significant difference between two groups （ P 〉0.05）.The incidence rate of adverse cardiac events in observation group was 5.00% （2/40）,which was significantly lower than that [27.27% （9/33）] in control group （ P 〈0.05）. Conclusion The higher dose of tirofiban can effectively improve the myocardial blood flow perfusion in patients with acute ST segment elevation myocardial infarction and can obviously reduce the incidence rates of postoperative adverse events , thus, which has higher feasibility and practicality .