急性ST段抬高心肌梗死急诊介入治疗中不同途径应用替罗非班的疗效分析

目的分析不同用药途径应用替罗非班对行经皮冠状动脉介入（perc．utaneoustransluminalcoronaryinter．vention，PCI）治疗的急性ST段抬高心肌梗死（ST—segmentelevationmyocardialinfarction，STEMI）患者的影响。方法选择首都医科大学大兴医院2009年11月～2012年4月收治的STEMI患者182例，分为观察组与对照组各91例。患者均行PCI术，术前应用替罗非班。观察组患者冠脉内用药，对照组患者静脉内用药。比较两组患者的术后疗效。结果观察组患者术后的心肌灌注分级（TMPG）3级率（86．81％）高于对照组患者（61．54％）（P〈0．05）；观察组患者术后的心肌梗死溶栓试验（TIMI）3级率（87．91％）高于对照组患者（41．76％）（P〈0．05）；两组患者住院期间及随访1个月内的主要心血管不良事件（MACE）发生率、术后出血并发症发生率和血小板减少症发生率比较，差异均无统计学意义沪〉0．05）。结论STEMI冠脉内替罗非班给药疗效安全可靠，建议临床推广。

Analysis of effect in different application ways of Tirofiban in emergency interventional therapy for ST-segment elevation myocardial infarction

Objective To analysis the effects of different application ways of Tirofihan in emergency percutaneous transluminal coronary intervention for ST-segment elevation myocardial infarction. Methods 182 patients with STEMI in the Capital Medical University Daxing Hospital were selected and divided into the observation group and the control group with 91 cases in each group. The patients were undergone PCI, preoperative application of Tirofiban. The intra- coronary drugs were used for patients in the observation group, the intravenous administration were used for patients in the control group. The curative effect of patients postoperative in the two groups were compared. Results The TMPG3 rate （86.81%） in observation group patients after operation was higher than control group patients （61.54%） （P 〈 0.05）; the TIMI3 rate of observation group patients after operation （87.91%） was higher than control group patients （41.76%） （P 〈 0.05）; two group patients during hospitalization and follow-up of 1 months, the MACE incidence and postopera- tive bleeding complications incidence and thrombocytopenia occurred rate were compared, there were no significant differences between them （P 〉 0.05）. Conclusion The efficacy of intraeoronary tirofiban administration for STEMI pa- tients were safety and reliability, recommendations for clinical used.