替罗非班在急性ST抬高心肌梗死患者择期PCI中的临床应用

目的探讨盐酸替罗非班在急性sT抬高心肌梗死（STEMI）患者择期冠脉介入治疗（PCI）中的疗效及安全性。方法将因错过急诊再灌注治疗时机的STEMI患者一周后行择期PCI术，随机分为替罗非班组（25例）和对照组（23例），替罗非班组术前开始应用替罗非班，持续至术后36—48h，对照组行常规PCI，观察两组冠脉复流、30d再梗及死亡情况，并观察其出血并发症、安全性。结果替罗非班组PCI术后无慢血流及无复流（TIM10—2级）发生，TIMI3级血流100％，对照组TIM10～2级血流发生率13．0％，TIMI3级87．0％，两组相比有统计学意义（P〈0．05），30d替罗非班组无再梗死及死亡。对照组再梗死及死亡发生率为4．3％，两组相比有统计学意义（P〈0．05）。替罗非班并不增加出血并发症。结论盐酸替罗非班在STEMI患者择期PCI中应用可改善冠脉血流，减少术后再梗及死亡，不增加出血并发症的发生。

The efficacy and safety of tirofiban in patients with STEMI during selective PCI

Objective To study the efficacy and safety of tirofiban in patients with STEMI during selective PCI. Methods Forty eight patients with STEMI who underwent selective PCI were randomly divided into tirofiban group（ n = 25 ）and control group（ n = 23 ）. Tirofiban was used in the former group before operation and continued for 36 - 48 hours after PCI. In control group, PCI was performed through routine process. The reflow rate ,30 days reinfarction rate, mortality and hemorrhage complications were recorded during the study. Results All patients in tirofiban group were recorded with TIMI 3 grade flow and neither slow-reflow nor no-reflow phenomena were observed. In control group 87.0% of patients restored TIMI 3 grade flow and 13.0% of patients were just recorded with TIMI 0-2 grade flow. The difference was found to be statistically significant（ P 〈 0. 05 ）. There was a lower reinfarction and mortality rate in the tirofiban group 30 days after the operation （ P 〈 0.05 ）. Hemorrhage complications were no increased in tow groups. Conclusion Tirofiban used in patients with STEMI during selective PCI can increase blood flow and reduce reinfarction rate. Tirofiban do not increase hemorrhage complications.