替罗非班联合氯吡格雷治疗行PCI术急性非ST段抬高型心肌梗死的临床疗效

Clinical effect of tirofiban combined with clopidogrel in treatment of patients with acute non-STelevation myocardial infarction undergoing percutaneous coronary intervention

目的替罗非班联合氯吡格雷治疗行经皮冠状动脉介入治疗(PCI)术急性非ST段抬高型心肌梗死的临床疗效。方法纳入本研究病例70例,来源于2017年1月至2019年1月在我院行经皮冠状动脉介入治疗(Percutaneous coronary intervention,PCI)术急性非ST段抬高型心肌梗死患者,按信封法分为对照组(n=35)及观察组(n=35),对照组以氯吡格雷治疗,观察组以替罗非班联合氯吡格雷治疗,比较两组患者治疗效果。结果观察组罪犯血管无复流发生率2.86%低于对照组的20.0%,TIMI 3级发生率94.29%高于对照组的48.57%,不良心血管事件发生率5.71%低于对照组的25.71%,差异有统计学意义(P<0.05)。观察组服药后2h MPAR低于对照组(P<0.05);两组术后30d出血事件发生率比较无差异(P>0.05)。结论替罗非班联合氯吡格雷用于行PCI术急性非ST段抬高型心肌梗死,可降低机体罪犯血管无复流现象,安全性高,临床价值高,值得推广。

Objective To investigate the clinical effect of tirofiban combined with clopidogrelin the treatment of patients with acute non-ST-elevation myocardial infarction undergoing percutaneous coronary intervention(PCI).Methods A total of 70 patients with acute non-ST-elevation myocardial infarction who underwent PCI in our hospital from January 2017 to January 2019 were enrolled and divided into control group and observation group using the envelope method,with 35 patients in each group.The patients in the control group were given clopidogrel alone,and those in the observation group were given tirofiban combined with clopidogrel.Clinical outcome was compared between the two groups.Results Compared with the control group,the observation group had a significantly lower incidence rate of no-reflow in the culprit vessel(2.86%vs 20.0%,P<0.05),a significantly higher incidence rate of grade 3 thrombolysis in myocardial infarction(94.29%vs 48.57%,P<0.05),and a significantly lower incidence rate of adverse cardiovascular events(5.71%vs 25.71%,P<0.05).Compared with the control group,the observation group had a significantly lower maximum platelet aggregation rate at 2 hours after administration(P<0.05).There was no significant difference between the two groups in the incidence rate of bleeding events on day 30 after surgery(P>0.05).Conclusion Inpatients with acute non-ST-elevation myocardial infarction undergoing PCI,tirofiban combined with clopidogrel can reduce no-reflow phenomenon in the culprit vessel and has high safety and clinical value.Therefore,it holds promise for clinical application.