替罗非班对急性心肌梗死急诊冠脉介入治疗的影响

目的评价急性心肌梗死患者急诊介入前持续静脉泵注替罗非班对介入治疗的影响。方法介入前79例急性心肌梗死患者，随机分为对照组（38例）、替罗非班组（41例）。两组均给予常规治疗，替罗非班组在常规治疗基础上加用替罗非班持续静脉泵注。观察两组急诊冠脉介入治疗（PCI）手术中冠脉造影前向血流充盈、冠脉血栓形成情况；术后72h心电图ST改变及缺血导联累及数；术后72h内室速及室颤发生总次数及术后主要终点事件。结果与对照组比较，术中替罗非班组前向血流TIMI分级明显提高（P〈0．05），冠脉内血栓形成减轻（P〈0．05）；术后心电图ST段缺血改善，缺血导联数下降，室速及室颤发生减少（均P〈0．05）；但术后主要终点事件发生率无差别（P〉0．05）。结论对急性心肌梗死患者，急诊冠脉介入前使用替罗非班可获得较好效果。

Effect of Tirofiban on the Therapy of Emergency Percutaneous Coronary Intervention in Patients with Acute Myocardial Infarction

Objective To evaluate the clinical effect of tirofiban administed by continuous pump-infusion on the therapy of percutaneous coronary intervention （PCI） in patients with acute myocardiac infarction（AMI）. Methods Before emergency PCI ,79 AMI patients were randomly divided into control group（ 38 cases） and Tirofiban group（41 cases）. Patients in control group received general treatment, patients in therapy group received general treatment in addition to Tirofiban by continuous pump-infusion. The TIMI grade of forward flow and coronary thrombosis were observed during emergency PCI. The change of ST segment and the number of ischemic lead in the ECG at 72 hours after PCI, the frequency of venticular tachycardia and ventricular fibrillation during 72 hours after PCI, and the main end point events after PCI also were ob- served. Results The TIMI grade of forward flow apparently increased as comnared with control group（ P 〈 0. 05 ）. Coronary thrombosis greatly decreased（ vs control, P 〈 0. 05 ）. There were also obvious improvement in ST segment（ vs control group, P 〈 0. 05 ）. As compared with control group, the number of ischemic leads significantly dropped （ P 〈 0. 05 ）, the frequency of ventricular tachycardia and ventricular fibrillation markedly reduced in the Tirofiban group （ P 〈 0. 05 ）. But, there was no difference of the main end point events between the control group and the Tirofiban group（ P 〉0. 05 ）. Conclusion AMI patients can receive better effect by Tirofiban administered by continuous pump-infusion before emergency PCI than the control group.