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目的探讨血小板糖蛋白Ⅱb/Ⅲa受体抑制剂盐酸替罗非班在急性心肌梗死经桡动脉冠状动脉介入治疗(PCI)中的疗效和安全性。方法将90例急性心肌梗死行经桡动脉PCI的患者随机分为替罗非班组和对照组,两组均使用阿司匹林、氯吡格雷(波立维)和低分子肝素,替罗非班组加用替罗非班,比较两组患者的复合终点事件,包括梗死后新出现的心绞痛+新发心肌梗死+死亡〔含血管重建事件:PCI或冠脉搭桥术(CABG)〕。结果替罗非班组和对照组患者30d内复合终点1、复合终点2及梗死后心绞痛的发生率间差别均有统计学意义(P<0·05),而新发心肌梗死和死亡单项终点的发生率间差别无统计学意义(P>0·05)。两组无再流或慢血流现象的发生率间差别有统计学意义(P<0·05)。两组出血率间差别无统计学意义(P>0·05)。结论盐酸替罗非班能明显降低缺血事件的发生,在经桡动脉PCI围术期与肝素、阿司匹林、氯吡格雷和低分子肝素联合治疗急性心肌梗死安全有效。
Objective To investigate the efficacy and safety of platelet glycoprotein Ⅱb / Ⅲa receptor inhibitor tirofiban in the treatment of acute myocardial infarction by radial artery coronary intervention (PCI). Methods Ninety patients with acute myocardial infarction who underwent radial artery PCI were randomly assigned to tirofiban and control groups. Both aspirin, clopidogrel and low molecular weight heparin were used in both groups. Tirofiban Non-classes, comparisons of composite endpoint events between the two groups included angina after infarction + new myocardial infarction + death [with revascularization event: PCI or coronary artery bypass grafting (CABG)]. Results There was significant difference in the incidence of composite end point 1, composite end point 2 and post-infarction angina pectoris within 30 days in patients treated with tirofiban and control group (P <0.05), while the incidence of new myocardial infarction and single endpoint of death The difference was not statistically significant (P> 0.05). There was a significant difference between the two groups in the incidence of no-reflow or slow blood flow (P <0.05). There was no significant difference in bleeding rate between the two groups (P> 0.05). Conclusion Tirofiban hydrochloride can significantly reduce the incidence of ischemic events and is safe and effective in the treatment of acute myocardial infarction with heparin, aspirin, clopidogrel and low molecular weight heparin during percutaneous transradial PCI.