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目的了解ST段抬高型急性心肌梗塞急诊冠状动脉介入治疗术中应用替罗非班是否改善冠脉血流和心肌灌注。方法将2007年1月至2010年5月因ST段抬高型急性心肌梗塞住院的72例患者随机分为两组A组(急诊介入术中应用替罗非班)与B组(急诊介入术中不应用替罗非班)。观察两组在常规使用阿斯匹林,氯吡格雷基础上介入治疗术后靶血管血流分级与心肌灌注分级及出血并发症的发生率。结果 A组急诊介入术后即刻靶血管TIMI血流2～3级(97.2%)心肌灌注(TMPG)2-3级(97.2%)均显著高于B组(91.6%,88.8%)。两组出血并发症比较差异无统计学意义。结论 ST段抬高型急性心肌梗塞急诊冠状动脉介入治疗术中应用替罗非班能有效改善冠脉血流和心肌灌注,并不增加出血风险。
Objective To investigate whether Tirofiban improves coronary blood flow and myocardial perfusion in patients with ST-elevation acute myocardial infarction undergoing coronary intervention. Methods From January 2007 to May 2010, 72 patients hospitalized with ST-elevation acute myocardial infarction were randomly divided into two groups: group A (tirofiban for emergency intervention) and group B (emergency intervention In the application of tirofiban). The incidences of target vessel blood flow classification, myocardial perfusion grading and bleeding complications after routine intervention with aspirin and clopidogrel were observed in both groups. Results The target vessel TIMI grade 2 ~ 3 (97.2%) and TMPG grade 2 (97.2%) were significantly higher in group A than those in group B (91.6%, 88.8%). There was no significant difference in bleeding complication between the two groups. Conclusion The application of tirofiban can effectively improve coronary blood flow and myocardial perfusion in patients with ST segment elevation acute myocardial infarction during coronary intervention without increasing the risk of bleeding.