不同时机使用替罗非班对急性心肌梗死急诊介入治疗冠脉血流及近期预后的临床研究

Clinical study of Tirofiban used at different time on coronary blood flow and short-term prognosis for an interventional emergency treatment of acute myocardial infarction

目的研究接受急诊介入治疗的急性心肌梗死患者在不同时机应用替罗非班对冠脉血流状况和近期预后的影响。方法抽取2014年12月~2016年12月我院急诊收治的急性心肌梗死患者92例,采用随机数字表法将其分为对照组、观察组,每组46例。对照组术后静脉注射替罗非班;观察组术前静脉注射替罗非班。比较两组介入术治疗前后冠脉TIMI血流分级、肌酸激酶同工酶、左心室射血分数;ST段完全回落率、住院期间不良心血管事件发生率。结果观察组患者治疗前后的冠脉TIMI血流分级、肌酸激酶同工酶、左心室射血分数的改善幅度大于对照组(P<0.05)。观察组ST段完全回落率为60.9%,高于对照组的32.6%(P<0.05)。观察组住院期间的不良心血管事件发生率为4.3%,低于对照组的23.9%(P<0.05)。结论接受急诊介入治疗的急性心肌梗死患者在术前通过静脉注射方式应用替罗非班的近期预后更理想,对冠脉血流相关指标可产生更积极、有利的影响。

Objective To study the influence of Tirofiban used at different time on coronary blood flow and short-term prognosis for an interventional emergency treatment of acute myocardial infarction （ACIS）.Metbods From December 2014 to December 2016,92 patients with AMI admitted into the emergency of our hospital were selected,and they were divid- ed into control group and observation group by a random number table.In the control group,Tirofiban was intravenously injected after surgery.In the observation group,Tirofiban was intravenously injected before surgery.The coronary TIM1 blood flow grade,creatine kinase isoenzyme,left ventricular ejection fraction before and after intervention,complete failing rate of ST segment and the incidence of adverse cardiovascular event between the two groups were compred.Re- suits The improve range of coronary TIMI blood flow grade,creatine kinase isoenzyme,left ventricular ejection fraction before and after treatment in the observation group were greater than that of the control group （P〈O.05）.The complete falling rate of ST segment in the observation group was 60.9%,and it was higher than that in the control group accounting for 32.6% with a statistical difference （P〈0.05）.The incidence of adverse cardiovascular event in the observation group was 4.3%,which was lower than that in the control group （23.9%） （P〈0.05）,which was lower than that of the control group （P〈 0.05）.Conclusion The short-term prognosis of Tirofiban applied before operation on coronary blood flow and short-term prognosis for an interventional emergency treatment of acute myocardial infarction is more ideal,and has a more positive effect on the related indexes of coronary artery blood flow compared with that injected after surgery.