盐酸替罗非班在急性ST段抬高型心肌梗死介入治疗中的有效性及安全性探讨

目的：观察血小板糖蛋白GPⅡb/Ⅲa受体拮抗剂盐酸替罗非班对急性ST段抬高型心肌梗死患者直接经皮冠状动脉介入治疗术（PCI）后的心肌灌注及安全性的影响。方法：选择急诊入院ST段抬高型心肌梗死患者62名,随机分为治疗组（盐酸替罗非班＋PCI）31例和对照组（PCI）31例。收集所有病例的临床和冠状动脉造影资料,观察PCI术后冠状动脉血流、出血并发症及住院期间不良心脏事件发生率（MACE）情况。结果：治疗组患者PCI术后TIMI 3级血流比例高于对照组（P〈0.05;100%vs 80.6%）。治疗组PCI术后ST段完全回落组（≥70%）的比例为38.7%,高于对照组的12.9%,差异具有统计学意义（P〈0.05）。两组患者在出血并发症及住院期间不良心脏事件发生率上的差异均无统计学意义（P〉0.05）。结论：盐酸替罗非班可改善急性STEMI患者梗死相关血管的血流灌注,且不增加出血并发症及住院期间不良心脏事件的发生。

Efficacy and safety of tirofiban in patients with acute ST-segment elevation myocardial infarction undergoing PCI

Objective：To investigate the effects of platelet glycoprotein Ⅱb/Ⅲa inhibitors（tirofiban）on microvascular flow and survival in patients with acute ST-segment elevation myocardial infarction（STEMI） after primary percutaneous coronary intervention（PCI）.Methods：Sixty-two patients with STEMI undergone primary PCI were randomized into therapy group of tirofiban plus PCI（n=31） and controls（primary PCI;n=31）.The clinical data and coronary arteriongraphy were obtained for examination of the coronary flow,complicated hemorrhage and frequencies of major adverse cardiac events（MACE） after PCI.Results：Higher postoperative incidence of Thrombolysis in Myocardial Infarction（TIMI） grade 3 was found in all patients of the therapy group as compared with the controls（100% vs 80.6%;P0.05）.38.7% of the patients in the therapy group were corrected with ST-segment complete resolution（≥70%） compared to their counterparts（12.9%）,which was different in statistics（P0.05）.Nevertheless,the two groups had no statistical difference regarding complicated hemorrhage after PCI and incidence of MACE during hospital stay（P0.05）.Conclusion：Tirofiban has shown modest improvements in patients with STEMI and striking reduction of complications after selective PCI.