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目的:观察血小板糖蛋白GPⅡb/Ⅲa受体拮抗剂盐酸替罗非班对急性ST段抬高型心肌梗死患者直接经皮冠状动脉介入治疗术(PCI)后的心肌灌注及安全性的影响。方法:选择急诊入院ST段抬高型心肌梗死患者62名,随机分为治疗组(盐酸替罗非班+PCI)31例和对照组(PCI)31例。收集所有病例的临床和冠状动脉造影资料,观察PCI术后冠状动脉血流、出血并发症及住院期间不良心脏事件发生率(MACE)情况。结果:治疗组患者PCI术后TIMI 3级血流比例高于对照组(P<0.05;100%vs 80.6%)。治疗组PCI术后ST段完全回落组(≥70%)的比例为38.7%,高于对照组的12.9%,差异具有统计学意义(P<0.05)。两组患者在出血并发症及住院期间不良心脏事件发生率上的差异均无统计学意义(P>0.05)。结论:盐酸替罗非班可改善急性STEMI患者梗死相关血管的血流灌注,且不增加出血并发症及住院期间不良心脏事件的发生。
Objective: To observe the effect of platelet glycoprotein GPⅡb / Ⅲa receptor antagonist tirofiban on myocardial perfusion and safety after percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction. Methods: Totally 62 patients with ST-segment elevation myocardial infarction were selected and randomly divided into treatment group (Tirofiban + PCI) and control group (31 cases). The clinical and coronary angiographic data of all cases were collected. The coronary blood flow, bleeding complications and incidence of adverse cardiac events (MACE) during hospitalization were observed. Results: The proportion of TIMI grade 3 blood flow after PCI in the treatment group was higher than that in the control group (P <0.05; 100% vs 80.6%). The percentage of patients with complete ST-segment depression (≥70%) after PCI in the treatment group was 38.7%, which was significantly higher than that in the control group (12.9%, P <0.05). No significant difference was found between the two groups in the incidence of bleeding complications and in-hospital adverse cardiac events (P> 0.05). CONCLUSION: Tirofiban hydrochloride improves infarction-related vascular perfusion in acute STEMI patients without increasing bleeding complications and adverse cardiac events during hospitalization.