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目的评价在常规抗凝血、抗血小板聚集的基础上,替罗非班联合急诊经皮冠状动脉介入(PCI)术治疗急性心肌梗死的疗效和安全性。方法把符合急性心肌梗死入选标准患者68例,随机分为治疗组和对照组各34例,治疗组微量泵持续泵入替罗非班,对照组微量泵持续泵入普通肝素。所有患者均口服阿司匹林、氯吡格雷、皮下注射低分子肝素。疗程均为2～3d。观察两组心电图改变、血小板聚集率、PCI术后血流情况及不良反应发生情况。结果与对照组相比,治疗组PCI术后血流情况和心电图缺血性改变有明显好转(P<0.01);血小板聚集率明显下降(P<0.01),无严重不良反应。结论替罗非班在急性心肌梗死的标准治疗基础上能进一步减少心肌缺血事件,改善PCI术后的冠脉血流,同时又具有较好安全性。
Objective To evaluate the efficacy and safety of tirofiban combined with emergency percutaneous coronary intervention (PCI) in the treatment of acute myocardial infarction (AMI) on the basis of conventional anticoagulant and antiplatelet aggregation. Methods A total of 68 patients with AMI criteria were randomly divided into treatment group (n = 34) and control group (n = 34). The patients in the treatment group were continuously injected with tirofiban, while those in the control group were continuously injected with unfractionated heparin. All patients were oral aspirin, clopidogrel, subcutaneous injection of low molecular weight heparin. Course of treatment are 2 ~ 3d. Electrocardiogram changes, platelet aggregation rate, blood flow after PCI and adverse reactions were observed in two groups. Results Compared with the control group, the blood flow and electrocardiographic ischemic changes after PCI in the treatment group were significantly improved (P <0.01). The platelet aggregation rate was significantly decreased (P <0.01) and no serious adverse reactions were observed. Conclusion Tirofiban can further reduce myocardial ischemic events and improve coronary blood flow after PCI based on the standard treatment of acute myocardial infarction. At the same time, it has good safety.