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目的评估替罗非班用于急性ST段抬高型心肌梗死(STEMl)患者急诊经皮冠状动脉介入治疗(PCI)时的安全性及有效性。方法已确诊的STEMI患者PCI术前随机分为试验组和对照组,试验组PCI术前静脉使用盐酸替罗非班。观察2组患者PCI术前、术后前向血流(TIMI)血流情况、术后1周左心室射血分数、出血并发症和30 d内发生心血管事件。结果与PCI组相比,替罗非班组PCI术后TIMIⅢ级血流获得率较PCI组高,差异有统计学意义(P<0.05);术后1周左室射血分数高于PCI组,差异有统计学意义(P<0.05),出血并发症发生率有高于PCI组趋势,但差异无统计学意义(P>0.05),无严重出血。30 d内的主要心血管事件发生率低于PCI组,差异有统计学意义(P<0.05)。结论替罗非班可改善STEMI患者梗死相关血管的TIMI血流,可安全用于STEMI的急诊介入治疗中,明显减少急性心肌梗死患者30 d内心血管事件的发生率。
Objective To evaluate the safety and efficacy of tirofiban in emergency percutaneous coronary intervention (PCI) in patients with acute ST-elevation myocardial infarction (STEMI). Methods Patients with confirmed STEMI were randomly divided into experimental group and control group before PCI. Tirofiban hydrochloride was given intravenously in the experimental group. The blood flow of TIMI before PCI, postoperative left ventricular ejection fraction 1 week, bleeding complications and cardiovascular events within 30 days were observed in two groups. Results Compared with the PCI group, the TIMI Ⅲ grade blood flow rate after PCI was higher in the tirofiban group than that in the PCI group (P <0.05), and the left ventricular ejection fraction The difference was statistically significant (P <0.05). The incidence of bleeding complication was higher than that of PCI group, but the difference was not statistically significant (P> 0.05). There was no severe bleeding. The incidence of major cardiovascular events within 30 days was lower than that of PCI group, with significant difference (P <0.05). Conclusion Tirofiban can improve infarction-related TIMI flow in STEMI patients and be safe for emergency interventional treatment of STEMI. The incidence of cardiovascular events within 30 days in acute myocardial infarction patients is significantly reduced.