替罗非班冠脉内注射对急性心肌梗死患者冠状动脉介入治疗预后的影响

目的观察替罗非班冠脉内注射对ST段抬高性急性心肌梗死(STE-MI)患者急诊冠状动脉介入治疗(PCI)预后的影响。方法将48例STEMI患者随机分为常规治疗组和替罗非班组,每组各24例。2组均给予常规药物治疗和急诊PCI治疗;在此基础上,替罗非班组在PCI时,冠脉内注射替罗非班(10μg.kg-1),术后以负荷量(0.4μg.kg-1.min-1,30 min)、然后维持量(0.1μg.kg-1.min-1)治疗48～72 h;用心肌梗死溶栓试验(TI-MI)和校正的TIMI计帧数(CTFC)测量法,评估PCI术后即刻结果、临床疗效、心肌损伤标志物水平、心血管事件和不良反应。结果 PCI后,TIMI血流3级获得率,替罗非班组高于常规治疗组(P=0.045);替罗非班组的CT-FC值小于常规治疗组(P=0.000)。治疗后3,7 d,血清CK、CK-MB和cT-nI水平,替罗非班组低于常规治疗组(均P<0.05)。结论替罗非班冠脉内注射治疗急性心肌梗死患者安全有效。

Effect of intracoronary injection of tirofiban for patients with acute myocardial infarction after percutaneous coronary intervention

Objective To evaluate the effect of intracoronary injection of tirofiban for patients with ST segment elevation myocardial infarction(STEMI) after percutaneous coronary intervention(PCI).Methods Forty-eight cases of STEMI patients were randomly divided into tirofiban group(n=24) and control group(conventional treatment,n=24).The instant results,curative effect,the serum level of myocardial creatase and major adverse cardiovascular events were evaluated after PCI.Results The thrombolysis in myocardiol infarction(TIMI) blood flow of tirofiban group was statistically higher than that in the control group(P=0.045).The corrected TIMI frame count of tirofiban group after PCI was statistically lower than that in the control group(P=0.000).The serum level of CK,CK-MB and cTnI at tirofiban group were statistically lower than that in the control group 3 d and 7 d after treatment(all P<0.05).Conclusion Intracoronary injection of tirofiban for patients with STEMI after PCI has an effective clinical application,which improve the prognosis and has clinical safety.