早期应用替罗非班对急性ST段抬高型心肌梗死急诊介入治疗的有效性及安全性分析

目的评价在急性ST段抬高型心肌梗死经皮冠状动脉介入治疗（PCI）中早期应用血小板膜糖蛋白Ⅱb／Ⅲa受体拮抗剂替罗非班的有效性和安全性。方法将80例急性ST段抬高型心肌梗死患者随机分为替罗非班组（替罗非班＋直接PCI，40例）和对照组（直接PCI，40例）。比较两组患者梗死相关动脉PCI后即刻TIMI血流、术后90min心电图ST段回落百分比、术后7d左室射血分数、术后30d内主要不良心脏事件（心绞痛、心肌梗死、死亡）、出血和血小板减少的发生率。结果替罗非班组PCI后慢复流发生率及主要不良心脏事件的发生率均低于对照组（P〈0．05），出血并发症的发生与对照组比较差异无统计学意义（P〉0．05）。结论早期应用替罗非班能改善急性ST段抬高型心肌梗死患者PCI后梗死相关血管的TIMI血流，减少PCI后主要不良心脏事件的发生率，临床应用安全有效。

The efficacy and safety of early using of tirofiban in patients with acute ST-segment elevation myocardial infarction accepted primary percutaneous coronary intervention(PCI)

Objective To evaluate the efficacy and safety of early use of platelet glycoprotein Ⅱb/Ⅲ a receptor antagonist tirofiban in patients with acute ST-segment elevation myocardial infarction accepted primary percutaneous coronary intervention （PCI） in. Methods 80 patients with acute ST-segment elevation myocardial infarction were randomly assigned to tirofiban （tirofiban ＋ direct PCI, n=40） and control group （direct PCI, n=40 patients）. The infarct-related artery TIMI flow immediately after PCI, sum-ST-segment resolution （sumSTR） after 90 min, left ventricular ejection fraction after 7 days, adverse cardiac events （angina, myocardial infarction, death） after 30 days and the incidence of bleeding and thrombocytopenia were compared. Results The incidence of slow-fellow after PCI and major adverse cardiac events rates were lower in tirofiban group, the difference was statistically significant （P〈0.05）, the difference of bleeding complications between two groups was not statistically significant （P〉0.05）. Conclusion Early application of tirofiban in patients with acute myocardial infarction can improve TIMI flow of the infarct related artery after PCI and reduce major adverse cardiac events, the evidence of clinical application is safe and effective.