依替巴肽与替罗非班在急性ST段抬高型心肌梗死病人PCI治疗中的疗效及安全性对比研究

Efficacy and Safety of Eptifibatide and Tirofiban in the Treatment of Acute ST-elevation Myocardial Infarction Patients Undergoing Percutaneous Coronary Intervention

目的对比研究依替巴肽和替罗非班在急性ST段抬高型心肌梗死(STEMI)病人行经皮冠状动脉介入术(PCI)中的疗效和安全性。方法选取于2016年1月—2016年12月我院收治的STEMI病人78例,随机分为依替巴肽组和替罗非班组,分别给予依替巴肽和替罗非班治疗。治疗后测定两组病人的血管再通、左心室射血分数(LVEF)和二磷酸腺苷(ADP)诱导的血小板聚集率,对比两组的治疗效果;术后,观察并记录两组病人的出血和血小板减少症的发生情况,对比两组的安全性。结果两组TIMI0级、1级和2级比例差异无统计学意义(P>0.05),依替巴肽组TIMI3级比例显著低于替罗非班组(P<0.05);两组TMPG0级、1级和2级比例差异无统计学意义(P>0.05),依替巴肽组TMPG3级比例显著低于替罗非班组(P<0.05);两组CTFC(帧数)和LVEF比较差异无统计学意义(P>0.05);依替巴肽组ADP诱导血小板聚集率显著高于替罗非班组(P<0.05)。两组出血和血小板减少症的发生率比较差异无统计学意义(P>0.05)。结论替罗非班能更好地促进STEMI病人的血管再通,抑制血小板聚集。

Objective To compare the efficacy and safety of eptifibatide and tirofiban in the treatment of acute ST-elevation myocardial infarction（STEMI）patients undergoing percutaneous coronary intervention（PCI）.Methods Seventy-eight patients with STEMI undergoing PCI from January 2016 to December 2016 were randomly divided into eptifibatide group and tirofiban group.Patients were given eptifibatide and tirofiban in the two groups,respectively.After the treatment,the blood vessel recanalization,left ventricular ejection fraction and adenosine diphosphate（ADP）-induced platelet aggregation rate were measured for the comparison of therapeutic effect.The bleeding and thrombocytopenia incidence were observed and recorded in both groups to evaluated the safety.ResultsThere was no significant difference in TIMI0,TIMI1 and TIMI2 between two groups（P〉0.05）,and the TIMI3 in eptifibatide group was significantly lower than that in tirofiban group（P〈0.05）.There was no significant difference in TMPG0,TMPG1 and TMPG2 between two groups（P〉0.05）,and the TMPG3 in eptacapine group was significantly lower than that in tirofiban group（P〈0.05）.There was no significant difference in CTFC（number of frames）and left ventricular ejection fraction（LVEF）between two groups（P〉0.05）.The platelet aggregation rate induced by ADP in eptifibatide group was significantly higher than that in tirofiban group（P〈0.05）.Conclusion Tirofiban can significantly improve vascular recanalization and reduce platelet aggregation in patients with STEMI undergoing PCI.