替罗非班对老年急性心肌梗死患者急诊PCI预后的影响

目的 探讨替罗非班对老年急性心肌梗死患者急诊冠状动脉介入治疗（PCI）临床预后的影响.方法 84例接受急诊PCI治疗的高龄ST段抬高急性心肌梗死（STEMI）患者,随机分为替罗非班常规冠脉内注射的治疗组（42例）和出现无复流、慢血流时替罗非班冠脉内注射的对照组（42例）.观察住院期间及随访3个月主要心血管事件（心源性死亡、非致死性心肌梗死、心绞痛）发生率;比较PCI术前后冠状动脉TIMI血流分级、TIMI心肌灌注分级（TMPG）和出血情况.结果 PCI术后,治疗组和对照组均能明显改善冠脉灌注（P〈0.05）,治疗组和对照组比较,冠状动脉前向血流TIMI 3级比例差异无统计学意义,而CTFC、TMPG 2～3级比例治疗组均显著高于对照组（P〈0.05）.治疗组和对照组比较,心血管事件发生率无显著差异,住院期间出血并发症比较,治疗组总体要高于对照组.结论 急诊PCI联合替罗非班治疗老年STEMI时,替罗非班常规冠脉内注射可改善冠状动脉梗死相关动脉前向血流,不能降低30 d内心血管事件的发生率,非主要的出血并发症有增高趋势.

Effect of Tirofiban on primary emergency percutaneous coronary intervention in older patients with acute myocardial

Objective To investigate the effect of Tirofiban on primary emergency pereutaneous coronary intervention（PCI） in the patients with acute myocardial infarction（AMI）. Methods 84 older patients admission in emergency department were randomized divided into two groups： management group（n=42） and control group （n= 42）. The TIMI grade, TIMI myocardial perfusion grade （TMPG） and bleeding were observed in both groups. After PCI, adverse cardiovascular events were also recorded in hospital and during 3 months follow-up. Results After PCI, the rate of adverse cardiovascular events had no significant difference between the two groups. The rate of TMPG 2-3 grade was higher in Tirofiban than in control group （P〈0.05）. There was no significant difference in MACEs between the two groups. In bleeding related adverse events during 3 months follow-up the management group has higher rate. Conclusion PCI routine application of Tirofiban could significantly improve forward blood flow and infarction relative coronary artery perfusion. However, routine use of Tirofiban also could induce no-important bleeding related adverse events.