目的探讨血栓抽吸导管联合替罗非班治疗老年急性ST性段抬高型心肌梗死(STEMI)患者的效果。方法老年急性STEMI患者71例按照多中心、双盲分组方式进行对照研究,A组35例,采取经皮冠状动脉介入(PCI)治疗单纯性导管抽吸治疗后植入药物支架;B组36例,在PCI治疗的基础上实施血栓抽吸导管联合替罗非班治疗,对比两组治疗期间不良反应、并发症情况,探析术后TIMI心肌灌注分级与心肌梗死溶栓血流发生情况。结果两组PCI治疗后,病情症状得到明显改善,其中B组恢复心肌梗死溶栓试验(TIMI)血流3级和心肌灌注分级(TMPG)3级患者均明显多于A组(P<0.05);两组治疗期间心肌梗死、心源性死亡、靶病变血运重建、靶血管血运重建发生率无明显差异(P>0.05);B组出院时左室射血分数(LVEF)明显高于A组(P<0.05)。结论老年急性STEMI患者急诊PCI治疗中给予血栓抽吸联合替罗非班治疗,可有效改善冠脉血流效率,提高心肌再灌注成功率,降低治疗期间无复流症状的发生率,提高心功能,控制心血管不良事件的发生。 Objective To investigate the efficacy of thrombus aspiration catheter combined with tirofiban in the treatment of elderly patients with acute ST-segment elevation myocardial infarction (STEMI). Methods Seventy-one elderly patients with acute STEMI were enrolled in this study according to a multicentre and double-blind method. Group A (35 cases) received percutaneous coronary intervention (PCI) Thrombus aspiration catheter combined with tirofiban was given on the basis of PCI. The adverse reactions and complications during the treatment were compared between the two groups, and TIMI myocardial perfusion grading and myocardial infarction thrombolytic blood flow were analyzed. Results The symptoms of the two groups were significantly improved after PCI. The levels of myocardial infarction thrombolysis (TIMI) grade 3 and myocardial perfusion grade 3 (TMPG) in group B were significantly higher than those in group A (P <0.05) There was no significant difference in the incidence of myocardial infarction, cardiac death, target revascularization and target vessel revascularization between the two groups (P> 0.05). The left ventricular ejection fraction (LVEF) in group B was significantly higher than that at discharge Group A (P <0.05). Conclusions Thrombolysis combined with tirofiban in emergency PCI for senile acute STEMI patients can effectively improve the coronary blood flow efficiency, improve the success rate of myocardial reperfusion, reduce the incidence of no-reflow symptoms and improve cardiac function , Control the occurrence of cardiovascular adverse events.