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目的观察急性ST段抬高型心肌梗死(ST-elevation myocardial infarction,STEMI)行急诊PCI术患者使用替罗非班的有效性及安全性。方法 80例患者随机分成两组:替罗非班组及对照组各40例。替罗非班组术中给予替罗非班,术后持续使用24h,随访7d。对照组不给予替罗非班,其余相同。观察两组术中TIMI血流分级,ST段回落百分比例,术后7d左室射血分数(LVEF),再灌注心律失常及术后7d内出血事件。结果替罗非班组PCI术后TIMI3级血流的例数明显高于对照组(38例VS30例,P<0.05),替罗非班组ST段回落百分比例与对照组相比差异有统计学意义(15例VS 7例,P<0.05)。替罗非班组和对照组PCI术后7d出血事件差异无统计学意义(P>0.05)。结论替罗非班可以增加急性ST段抬高型心肌梗死患者PCI术中TIMI 3级血流,可增加ST段回落百分比,不增加术后7d内出血事件。
Objective To investigate the efficacy and safety of tirofiban in patients with acute ST-elevation myocardial infarction (STEMI) undergoing emergency PCI. Methods 80 patients were randomly divided into two groups: Tirofiban group and control group, 40 cases each. Tirofiban group was given tirofiban intraoperatively, 24h after operation and 7 days after operation. The control group did not receive tirofiban, the rest were the same. The TIMI grade, ST-segment decline percentage, left ventricular ejection fraction (LVEF), reperfusion arrhythmia and postoperative bleeding within 7 days were observed in the two groups. Results Tirofiban group had a significantly higher TIMI grade 3 blood flow rate after PCI (38 cases vs 30 cases, P <0.05). There was a significant difference in the percentage of ST-segment decline between tirofiban group and control group (15 cases VS vs 7 cases, P <0.05). Tirofiban group and control group 7d after PCI bleeding event was no significant difference (P> 0.05). Conclusion Tirofiban can increase TIMI grade 3 blood flow in patients with acute ST-segment elevation myocardial infarction, increase the percentage of ST-segment depression, and do not increase the incidence of hemorrhage within 7 days after operation.