经皮冠状动脉介入联合替罗非班治疗急性心肌梗死

目的：探讨替罗非班治疗心肌梗死患者经皮冠状动脉介入治疗（PCI）后血运重建不良方面的临床疗效，为该类疾病的临床治疗提供参考。方法以第三军医大学大坪医院2009年2月至2013年1月收治的200例PCI术中出现“无复流”或“慢血流”的心肌梗死患者为研究对象，将其随机分为对照组和治疗组。对照组PCI术中加用硝酸甘油，治疗组加用硝酸甘油和替罗非班。观察两组患者的临床治疗效果。结果治疗后，对照组与治疗组患者的TIMI血流分级和TMP心肌灌注分级均有明显改善，且差异有统计学意义（P＜0．05）。治疗组TIMI血流分级与TMP心肌灌注分级明显高于对照组，差异有统计学意义（P＜0．05）。治疗后，两组患者的校正TIMI帧数均优于治疗前，且治疗组优于对照组，差异有统计学意义（P＜0．05）。1周后，治疗组患者的左心室舒张末期直径和左心室射血分数均优于对照组，且组间差异有统计学意义（P＜0．05）。结论PCI术中加用替罗非班能够有效改善急性心肌梗死患者的血运重建不良症状，其临床疗效比单独使用硝酸甘油时更为理想。

A study about the clinical efficacy of PCI joint with tirofiban in patients with AMI

Objective To investigate the clinical effect of tirofiban for the treatment of acute myocardial infarc‐tion（AMI） patients with poor blood supply after percutanecus coronary intervention（PCI） .Methods A total of 200 AMI patients with blood flowing slowly and no‐reflow were selected as the objects in Daping Hospital Affiliated to the Third Military Medical University from February 2009 to January 2013 .All the patients were divided into treat‐ment group and control group randomly .The control group was treated with nitroglycerin after PIC ,the treatment group was treated with nitroglycerin and tirofiban after PIC .Compared the clinical effect of the two groups after re‐ceived treatment .Results After treatment ,the thrombolysis in myocardial infarction （TIMI） flow grade and the my‐ocardial perfusion （ TMP） grade of the two groups were all better than those pre-treatment ,and the differences be‐tween pre-treatment and post -treatment were statistically significant （P〈0 .05） .The TIMI flow grade and the TMP grade of treatment group were higher than those of the control group ,and the difference was statistically signif‐icant （P〈0 .05） .The post-treatment corrected TIMI frame count （CTFC） of the two groups was better than that pre-treatment （P〈 0 .05） ,and the treatment group was better than control group （P〈 0 .05） .After treating 1 week ,the left ventricular end-diastolic dimension （ LVEDD） and left ventricular ejection fraction （LVEF） of treat‐ment group was better than those of the control group ,and the differences were statistically significant （P〈0 .05） . Conclusion Using tirofiban during the operation of PCI could effectively improve the adverse revascularization ,the clinical effect was better than nitroglycerin using alone .