替罗非班在急性心肌梗死择期冠脉介入治疗术中的应用

目的观察替罗非班在急性心肌梗死（AMI）行择期冠状脉介入治疗（PCI）术中应用的疗效和安全性。方法 87例AMI患者随机分为治疗组43例,对照组44例,均于起病8～12d行PCI。治疗组在PCI术中即刻经冠脉内推注替罗非班10μ/kg,3min内推注完。后以0.15μg/（kg.min）持续静脉泵入36h。术前、术后均服氯吡格雷、阿司匹林、阿托伐他汀钙。术后加用低分子肝素钠6000U,1次/12h×8d。对照组除不用替罗非班外,治疗均相同。观察PCI前后梗死相关血管TIMI血流,术后4周内出血并发症和主要不良心血管事件（MACE）发生情况。结果梗死相关血管TIMI血流3级治疗组高于对照组,差异有统计学意义（P〈0.05）。出血并发症两组差异无统计学意义（P〉0.05）;MACE治疗组明显低于对照组,有统计学意义（P〈0.05）。结论基层医院AMI择期PCI应用替罗非班安全有效。

Application of Tirofiban in patients with acute myocardial infarction treated by elective percutaneous coronary intervention

Objective To evaluate the safety and efficacy of tirofiban in patients with acute myocardial infarction（AMI）treated by elective percutaneous coronary intervention（PCI）.Methods 87 AMI patients were randomly group.All the individuals were performed PCI with 8～12 hours after onset of AMI Immediately after PCI all the individuals of tirofiban group were intravenously administered tirofiban（10μg/kg）in 30 mins,following tirofiban（0.15μg/kg·mg）by continuous intravenous pumped in 36 hours.All the individuals were administered clopidogrel,aspirin and atorvastatin calcium tablets before ang after PCI.All the individuals were intravenously administered low molecular weight heparin sodium 6000μ in 8days after PCI.Thrombolysis in acute myocardial infarction（TIMI）grade was studied before and after PCI.Thrombolysis in acute myocardial infarction（TIMI）grade was studied before and after PCI.All the individuals in contral group weren＇t administered tirofiban,but other therapeutic treatments were the same to those in tirofiban group.The major advere cardiac（MACE）in 4 weeks and bleeding complications were studied.Results In tirofiban group,TIMI 3 flow of the infarction related artery in patients in tirofiban group was higher than those in control group（P0.05）,The occurance of bleeding complication was no significant difference in both groups（P0.05）,the occurrence of MACE in tirofiban group was significantly lower than those in control group（P0.05）.Conclusion Application of tirofiban during elective PCI in patients with AMI was safe and effective in primary hospital.