替罗非班对老年急性心肌梗死患者急诊直接介入治疗的应用价值

目的评价老年急性心肌梗死患者急诊直接PCI中简化应用血小板膜糖蛋白Ⅱb/Ⅲa受体拮抗剂替罗非班的价值。方法选择行急诊直接PCI的老年急性心肌梗死患者105例,随机分为替罗非班组57例和对照组48例。替罗非班组接受简化应用替罗非班方案(术前、术后使用,术中不使用),对照组不使用。分析2组的基线资料、即刻手术成功率、肌钙蛋白、出血和血小板减少情况,观察住院和随访30 d主要心脏不良事件及30 d LVEF。结果 2组患者均急诊直接PCI成功。替罗非班组冠状动脉造影时,梗死相关动脉前向血流明显优于对照组,24 h肌钙蛋白水平明显低于对照组(P<0.05),术后血小板计数比较差异无统计学意义(P>0.05)。2组患者住院及随访期间,均无主要心脏不良事件发生,2组患者出血情况比较差异无统计学意义(P>0.05)。替罗非班组30 dLVEF明显优于对照组(P<0.05)。结论老年急性心肌梗死患者急诊直接PCI简化应用替罗非班安全、有效。

Simple use of tirofiban in elderly patients with acute myocardial infarction undergoing primary percutaneous coronary intervention

Objective To explore the value of simple use of tirofiban in elderly patients with acute myocardial infarction(AMI) undergoing primary percutaneous coronary intervention(PCI).Methods 105 patients with AMI undergoing primary PCI were randomly divided into two groups:the tirofiban group(n=57)and the control group(n=48).Tirofiban was simply used in the first group (pre-PCI and post-PCI,no tirofiban was used during PCI).The basic characteristics,immediate success rate of PCI,TnI,platelet counts,and the bleeding complications were recorded.Clinical main adverse cardiac events(MACE) and the LVEF on day 30 were analyzed.Results The primary PCI of all patients was successful.When CAG finished,the blood flow of the infarction-related artery in the tirofiban group was superior to that in control group(P<0.05),so was the TnI level. There was no difference of the platelet counts between the two groups(P>0.05).No MACE was recorded in all patients.The bleeding complication was similar(P>0.05),but the LVEF on day 30 of the tirofiban group was higher than that of the control group(P<0.05).Conclusion The simple use of tirofiban was safe and effective for elderly patients with AMI undergoing primary PCI.