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目的探讨急诊经冠状动脉介入治疗术(PCI)术前应用盐酸替罗非班对ST段抬高型心肌梗死患者的左心室功能及预后的影响。方法选择2011年1月至2012年9月在南阳医学高等专科学校第二附属医院进行急诊PCI治疗的118例急性ST段抬高型心肌梗死患者做为观察对象,随机将118例患者分成两组,实验组与对照组,每组59例,对照组患者在急诊PCI术前常规服用阿司匹林及氯吡格雷,实验组患者在对照组的基础上应用盐酸替罗非班,比较两组患者在手术后7d及60d的左心室功能及术后90d主要不良心脏事件(MACE)的发生率与出血并发症发生率。结果实验组患者术后7d及60d的左心室功能明显优于对照组(P<0.05),差异有统计学意义;两组术后90d主要不良心脏事件(MACE)的发生率与出血并发症发生率相比无明显差异(P>0.05),差异无统计学意义。结论 ST段抬高型心肌梗死患者行急诊PCI术前应用盐酸替罗非班能明显改善患者的左心室功能,提高临床预后,且不会增加出血并发症的发生率,可在临床中推广应用。
Objective To investigate the effect of preoperative application of tirofiban hydrochloride on left ventricular function and prognosis in patients with ST-elevation myocardial infarction undergoing percutaneous coronary intervention (PCI). Methods From January 2011 to September 2012, 118 patients with acute ST-elevation myocardial infarction who underwent emergency PCI in the Second Affiliated Hospital of Nanyang Medical College were enrolled in this study. One hundred and eighty-eight patients were randomly divided into two groups , The experimental group and the control group, 59 cases in each group. Patients in the control group were given aspirin and clopidogrel before emergency PCI. The patients in the experimental group were given tirofiban hydrochloride on the basis of the control group. Left ventricular function at 7d and 60d after operation and the incidence of major adverse cardiac events (MACE) and bleeding complication at 90 days after operation. Results The left ventricular function of the experimental group was significantly better than that of the control group at 7d and 60d after operation (P <0.05), and the difference was statistically significant between the two groups in the incidence of major adverse cardiac events (MACE) and bleeding complications No significant difference (P> 0.05), the difference was not statistically significant. Conclusion The application of tirofiban hydrochloride before ST-segment elevation myocardial infarction in patients with ST-segment elevation myocardial infarction can significantly improve left ventricular function, improve clinical prognosis, and will not increase the incidence of bleeding complications, which can be widely used in clinical practice .