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目的观察替罗非班冠脉内注射对ST段抬高性急性心肌梗死(STE-MI)患者急诊冠状动脉介入治疗(PCI)预后的影响。方法将48例STEMI患者随机分为常规治疗组和替罗非班组,每组各24例。2组均给予常规药物治疗和急诊PCI治疗;在此基础上,替罗非班组在PCI时,冠脉内注射替罗非班(10μg.kg-1),术后以负荷量(0.4μg.kg-1.min-1,30 min)、然后维持量(0.1μg.kg-1.min-1)治疗48～72 h;用心肌梗死溶栓试验(TI-MI)和校正的TIMI计帧数(CTFC)测量法,评估PCI术后即刻结果、临床疗效、心肌损伤标志物水平、心血管事件和不良反应。结果 PCI后,TIMI血流3级获得率,替罗非班组高于常规治疗组(P=0.045);替罗非班组的CT-FC值小于常规治疗组(P=0.000)。治疗后3,7 d,血清CK、CK-MB和cT-nI水平,替罗非班组低于常规治疗组(均P<0.05)。结论替罗非班冠脉内注射治疗急性心肌梗死患者安全有效。
Objective To observe the effect of Tirofiban injection on the prognosis of patients undergoing emergency coronary intervention (PCI) with ST-elevation acute myocardial infarction (STE-MI). Methods Forty-eight STEMI patients were randomly divided into conventional treatment group and tirofiban group, 24 cases in each group. Both groups were given conventional medical treatment and emergency PCI. On this basis, tirofiban group was injected with tirofiban (10μg.kg-1) intracoronaryly at PCI and postoperatively at loading (0.4μg. kg-1.min-1,30 min), and then maintained for 48-72h (0.1μg.kg-1.min-1); myocardial infarction thrombolysis test (TI-MI) (CTFC) measurement to assess immediate outcomes after PCI, clinical efficacy, levels of myocardial injury markers, cardiovascular events, and adverse events. Results After PCI, the TIMI grade 3 blood flow rate was higher in the tirofiban group than in the conventional treatment group (P = 0.045). The CT-FC value in the tirofiban group was smaller than that in the conventional treatment group (P = 0.000). Serum levels of CK, CK-MB and cT-nI at 3 and 7 days after treatment were lower in the tirofiban group than those in the conventional treatment group (all P <0.05). Conclusion Tirofiban is safe and effective in the treatment of acute myocardial infarction.