替罗非班在急性ST段抬高型心肌梗死患者急诊PCI中的临床观察

Clinical Observation of Tirofiban in Patients with Acute ST-segment Elevation Myocardial Infarction Treated by Emergency Percutaneous Coronary Intervention

目的探讨替罗非班在急性ST段抬高型心肌梗死(STEMI)患者急诊直接经皮冠状动脉介入(PCI)中的临床疗效。方法选取我院心血管内科于2016年7月至2017年6月期间100例(观察组50例、对照组50例)急性ST段抬高型心肌梗死直接PCI治疗患者进行回顾性分析,对照组采用低分子肝素、阿司匹林、氯吡格雷等药物治疗,观察组在对照组的基础上加用替罗非班。比较两组患者病变发生血管的心肌梗死溶栓试验(TIMI)血流分级的情况,住院期间的主要不良心血管事件及出血风险。结果观察组的出血风险与对照组比较无统计学差异(P>0. 05);观察组术后TIMI3级血流达到96%,对照组术后TIMI3级血流仅达到82%,两组比较差异有统计学意义(P <0. 05);观察组住院期间再发心梗和心力衰竭的发生率明显低于对照组,差异均有统计学意义(P <0. 05)。结论替罗非班通过冠状动脉内注射可明显改善急诊PCI中急性ST段抬高型心肌梗死患者的再灌注水平,不增加出血风险,从而改善患者症状及预后。

OBJECTIVE To explore the effect of tirofiban on ST-elevation myocardial infarction （STEMI） patients undertaking urgent percutaneous coronary intervention （PCI）. METHODS 100 patients with STEMI undertaking emergency PCI at the deparment of cardiology in our hospital were enrolled retrospectively from July 2016 to June 2017.These 100 patients were divided into two groups,the treatment group and the control group.The control group was administrated with low-molecular-weight heparin （LMWH）,aspirin and clopidogrelas foundation,while the treatment group was treated with tirofiban besides thebasic administration.The thrombolysis in myocardial infarction （TIMI） flow grades,major adverse cardiovascular events and risk of hemorrhage were compared between the two groups. RESULTS No difference was found inthe risk of hemorrhage between two groups （ P 〉0.05）.The TIMI flow grade was significantly different in two groups,TIMI-3 was calculated up to 96% in treatment group,while 82% patients in control group had TIMI-3（ P 〈0.05）.The recurrence rate of myocardial infarctionand the incidence of cardiac failure in treatment group were significantly lower than control group during hospitalization（ P 〈0.05）. CONCLUSION Tirofiban elevated the myocardial reperfusion,and improved the syndrome and outcome of STEMI patients undertaking PCI without increasing the risk of bleeding.