急性ST段抬高型心肌梗死PCI术中冠状动脉内注射替罗非班对改善心肌灌注的临床研究

Improvement of myocardial perfusion in patients with acute ST segment elevation myocardial in-farction by intravascular injection of tirofiban in PCI

目的 分析急性ST段抬高型心肌梗死经皮冠状动脉介入（PCI）术中冠状动脉内注射替罗非班对改善患者心肌灌注的价值和意义.方法 选取急性心肌梗死患者100例作为研究对象,依据住院单双号原则将其分为对照组与观察组,每组50例.所有患者均接受PCI治疗,其中观察组在术中直接向冠状动脉内注入替罗非班治疗,对照组则在术中通过静脉注入替罗非班治疗,比较不同治疗方案对改善心肌灌注的疗效差异.结果 与对照组比较,观察组PCI术后即刻心肌梗死溶栓（TIMI）3级血流获得率明显增加,差异有统计学意义（P〈0.05）;随访期间,观察组术后半年主要心血管事件发生率明显低于对照组,差异有统计学意义（P〈0.05）.结论 急性心肌梗死直接行PCI术中冠状动脉注射替罗非班治疗,有助于改善患者心肌微循环血流,降低主要心血管事件的发生率,效果显著,值得临床推广应用.

Objective To analyze the value and significance of intracoronary injection of tirofi-ban in patients with acute ST segment elevation myocardial infarction during percutaneous coronary inter-vention （PCI）. Methods A hundred patients with acute myocardial infarction were selected as the re-search subjects and were divided into control group and observation group according to the number of hos-pital admission and odd number, with 50 cases in each group. All patients were treated by PCI. In obser-vation group, tirofiban was injected into the coronary artery and control group was treated by intravenous injection of tirofiban. The effects of different treatments on improving myocardial perfusion werecompared. Results Compared with control group, the rate of immediate thrombolysis in myocardial in-farction （TIMI） grade 3 blood flow in observation group was significantly increased after PCI, and the difference was statistically significant （P 〈 0. 05). During the follow-up period, the incidence of major artery during PCI is helpful to improve the blood flow of myocardial microcirculation and reduce the inci-dence of major cardiovascular events. It is effective and worthy of clinical application.