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目的评价冠脉内注射血小板膜糖蛋白(GP)Ⅱb/Ⅲa受体拮抗剂盐酸替罗非班在急性ST段抬高型心肌梗死(STEMI)急诊经皮冠状动脉介入(PCI)治疗中的安全性及有效性。方法我院急性STEMI冠脉造影(CAG)显示梗死相关血管(IRA)有血栓征象的患者67例,分成试药组(PCI前冠脉内注射盐酸替罗非班+PCI,n=35)与对照组(直接PCI,n=32),对比2组患者PCI术中IRA远端TIMI血流,术后左室射血分数(LVEF),住院期间的主要不良心血管事件(MACE)及出血情况。结果试药组术中无再流及再灌注心律失常的发生率明显低于对照组(3%vs19%;3%vs16%,P<0.05);试药组术后LVEF明显高于对照组[(57±5)%vs(51±10)%,P<0.05];住院期间MACE发生率试药组低于对照组(3%vs9%),两组均未发生严重出血并发症。结论急诊PCI前冠脉内缓慢注射盐酸替罗非班对急性STEMI患者行急诊PCI安全有效。
Objective To evaluate the safety of intracoronary injection of platelet glycoprotein (GP) Ⅱb / Ⅲa receptor antagonist tirofiban in patients undergoing acute percutaneous coronary intervention (PCI) with acute ST-segment elevation myocardial infarction (STEMI) Sexuality and effectiveness. Methods Sixty-seven patients with signs of thrombosis in the infarction-related vessels (IRA) underwent acute STEMI coronary angiography (CAG) in our hospital were divided into two groups: experimental group (PCI, n = 35) The control group (direct PCI, n = 32) compared the distal IRI TIMI flow, postoperative left ventricular ejection fraction (LVEF), major adverse cardiovascular events (MACE) during hospitalization and bleeding in two groups . Results The incidence of no-flow and reperfusion arrhythmia in the experimental group was significantly lower than that in the control group (3% vs 19%; 3% vs 16%, P <0.05); LVEF in the experimental group was significantly higher than that in the control group [ (57 ± 5)% vs (51 ± 10)%, P <0.05]. The incidence of MACE during hospitalization was lower in the test group than in the control group (3% vs 9%). No severe bleeding complications occurred in both groups. Conclusions The emergency PCI of Tilapisone Hydrochloride in patients with acute STEMI can be safely and effectively treated with emergency PCI before emergency PCI.