延长急诊PCI术后替罗非班时限对急性心肌梗死疗效的影响

Effect of extending the time limit of tirofiban after emergency PCI on acute myocardial infarction

目的:探讨急性心肌梗死(AMI)患者急诊经皮冠状动脉介入治疗(PCI)术后延长替罗非班治疗的疗效。方法:将2017年1月至2019年12月本院收治的108例AMI患者,按随机数字表法分成对照组和试验组。对照组仅术中冠脉内注射500μg替罗非班,试验组术前静脉推注500μg,术中堵塞的冠脉血管开通后再次给予500μg冠脉内注射,术后250μg/h静脉持续泵入24 h。比较两组的一般资料、主要心血管不良事件(MACE)及单一终点事件和安全性。结果:试验组MACE发生率低于对照组(P=0.032)。与对照相比,试验组发生MACE事件的时间延长(P<0.05),单一终点事件差异无统计学意义(P>0.05);试验组心肌梗死再住院、支架内血栓形成、支架内再狭窄等次要终点事件的发生率均低于对照组(均P<0.05),两组安全性差异无统计学意义(均P>0.05)。结论:在AMI患者中急诊PCI术后延长替罗非班治疗,可降低主要不良血管事件的风险,同时不增加出血风险。

Objective: To explore the therapeutic effect of prolonging tirofiban treatment time after percutaneous coronary intervention(PCI) in patients with acute myocardial infarction(AMI). Methods: The sample consisted of 108 patients with AMI in our hospital from January 2017 to December 2019. Participants were randomly divided into control group and experimental group. The patients in the control group only received 500 μg tirofiban via intra-coronary injection during PCI. In the experimental group, 500 ingtirofiban was injected intravenously before operation, and 500 injtirofiban was injected via intra-coronary again after the blocked coronary artery was opened during operation;after operation, tirofiban was continuously pumped intravenously for 24 h at 250 μg/h.The general information, major adverse cardiovascular events(MACE), single endpoint events and safety were compared. Results: Compared with the control group, the incidence and occurrence time of MACE in the experimental group was longer(P<0.05), while no significant difference was found in the single endpoint event between groups(P>0.05). The incidence of secondary endpoint events such as myocardial infarction rehospitalization, stent thrombosis and stent restenosis in the experimental group was lower than that in the control group(P<0.05). There was no significant difference in safety between the two groups(P>0.05). Conclusion: In AMI patients, extending tirofiban treatment time after emergency PCI can reduce the risk of major adverse vascular events without increasing the risk of bleeding.