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目的:评价血小板膜糖蛋白Ⅱb/Ⅲa受体拮抗剂盐酸替罗非班在急性心肌梗死(AMI)患者急诊冠状动脉介入治疗(PCI)中的有效性和安全性。方法:将106例AMI患者随机分为替罗非班组(替罗非班+直接PCI,55例)和对照组(直接PCI,51例)。比较2组患者梗死相关动脉PCI后即刻TIMI血流,术后90 min心电图ST段回落百分比(sumSTR),术后6 h、12 h肌酸激酶同工酶变化,术后1周左室射血分数,术后30 d内不良心脏事件(心绞痛、心肌梗死、死亡)及出血和血小板减少的发生率。结果:2组基础临床情况和冠状动脉造影特征无明显差异。替罗非班组梗死相关动脉PCI术后即刻TIMI血流、术后90 min sumSTR均显著高于对照组;术后30 d内不良心脏事件明显少于对照组;术后6 h、12 h肌酸激酶同工酶变化、术后1周左室射血分数与对照组相比差异无统计学意义。替罗非班组轻度出血发生率高于对照组,但未发生严重出血和血小板减少症。结论:替罗非班能明显降低AMI患者PCI后缺血事件的发生,在急诊PCI中是有效而安全的。
AIM: To evaluate the efficacy and safety of platelet glycoprotein Ⅱb / Ⅲa receptor antagonist tirofiban in emergency PCI (PCI) in patients with acute myocardial infarction (AMI). Methods: One hundred and six patients with AMI were randomly divided into Tirofiban (Tirofiban + 55 cases) and control group (51 cases). The TIMI blood flow immediately after infarction-related artery PCI was compared between the two groups. The percentage of ST ST segment decline (sumSTR) at 90 min after operation, the change of creatine kinase isoenzyme at 6 h and 12 h after operation, left ventricular ejection fraction Scores, adverse cardiac events (angina pectoris, myocardial infarction, death) and the incidence of bleeding and thrombocytopenia within 30 days after surgery. Results: There was no significant difference between the two groups in basic clinical features and coronary angiography. Tirofiban group infarction related artery TIMI blood flow immediately after PCI, sumSTR 90 min postoperatively was significantly higher than the control group; 30 d after the adverse cardiac events were significantly less than the control group; 6 h, 12 h after the creatine The changes of kinase isoenzyme, left ventricular ejection fraction 1 week after surgery compared with the control group showed no significant difference. The incidence of mild bleeding in the tirofiban group was higher than in the control group, but severe bleeding and thrombocytopenia did not occur. Conclusion: Tirofiban can significantly reduce the occurrence of ischemic events after AMI in patients with AMI, which is effective and safe in emergency PCI.