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目的:探讨冠状动脉内应用替罗非班或尼可地尔对急性ST段抬高型心肌梗死（STEMI）患者经皮冠状动脉介入治疗（PCI）术后临床效果的影响。方法:选取2017年1月至2020年1月合肥高新心血管病医院收治的198例STEMI患者，采用随机数字表法分为替罗非班组、尼可地尔组和对照组各66例。替罗非班组、尼可地尔组和对照组分别于PCI术前冠状动脉内给予替罗非班、尼可地尔、0.9%氯化钠，术后三组均予常规药物治疗。记录三组手术前后心肌梗死溶栓治疗（TIMI）血流分级、TIMI心肌灌注分级（TMPG）情况，统计三组术后校正TIMI血流计帧数（cTFC）、TIMI心肌灌注帧数（TMPFC）、血清肌酸激酶（CK）峰值水平、肌酸激酶同工酶（CK-MB）峰值水平。记录三组PCI术中再灌注心律失常、严重低血压、围手术期出血情况及术后3个月内主要不良心脏事件（MACE）例数。结果:术后替罗非班组和尼可地尔组的TIMI血流分级和TMPG明显优于对照组（n P0.05）。替罗非班组cTFC、TMPFC、CK峰值水平、CK-MB峰值水平、再灌注心律失常发生率和MACE发生率均明显低于对照组[（25.32 ± 5.11）和（25.17 ± 5.38）帧比（29.85 ± 7.63）帧、（93.84 ± 13.46）和（94.74 ± 13.17）帧比（101.38 ± 18.52）帧、（1 095.32 ± 306.36）和（1 113.19 ± 385.68）U/L比（1 669.81 ± 537.61）U/L、（191.81 ± 63.31）和（189.72 ± 62.22）U/L比（341.68 ± 108.57）U/L、19.70%（13/66）和18.18% （12/66）比36.36%（24/66）、18.18%（12/66）和21.21%（14/66）比39.39%（26/66）]（n P0.05）。n 结论:术前冠状动脉内应用替罗非班或尼可地尔有助于改善STEMI患者PCI术后心肌功能和微循环障碍，对改善患者心功能短期预后具有积极作用。“,”Objective:To explore the effects of intracoronary application of tirofiban or nicorandil in patients with acute ST-segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI).Methods:A total of 198 STEMI patients who were admitted to Hefei High-Tech Cardiovascular Hospital during the period from January 2017 to January 2020 were enrolled. They were divided into tirofiban group, nicorandil group and control group by random number table method, with 66 cases in each group. Patients in the tirofiban group, nicorandil group and control group were given tirofiban, nicorandil and 0.9% sodium chloride in coronary artery before PCI, respectively. After surgery, the three groups were given routine drugs. TIMI blood flow grade and TIMI myocardial perfusion grade (TMPG) before and after surgery in the three groups were recorded. The corrected TIMI frame count (cTFC), TIMI myocardial perfusion frame count (TMPFC), peak levels of serum creatine kinase (CK) and creatine kinase isoenzymes (CK-MB) after surgery in the three groups were statistically analyzed. The reperfusion arrhythmias in PCI, severe hypotension and perioperative bleeding, and number of cases with major adverse cardiac events (MACE) within 3 months after surgery in the three groups were recorded.Results:After surgery, number of cases with TIMI blood flow grading at grade 0- 3 in tirofiban group, nicorandil group and control group was (0, 2, 4, 60) cases, (0, 1, 4, 61) cases and (1, 4, 9, 52) cases, respectively. The number of cases with TMPG grading at grade 0- 3 in tirofiban group, nicorandil group and control group was (0, 3, 6, 57)cases, (0, 2, 5, 59) cases and (1, 5, 11, 49) cases, respectively. TIMI blood flow grading and TMPG in tirofiban group and nicorandil group were significantly better than those in control group (n P0.05). The cTFC, TMPFC, peak level of CK, peak level of CK-MB, incidence of reperfusion arrhythmia and incidence of MACE in tirofiban group, nicorandil group and control group were [(25.32 ± 5.11) frames, (93.84 ± 13.46) frames, (1 095.32 ± 306.36) U/L, (191.81 ± 63.31) U/L, 19.70%, 18.18%], [(25.17 ± 5.38) frame, (94.74 ± 13.17) frame, (1 113.19 ± 385.68) U/L, (189.72 ± 62.22) U/L, 18.18%, 21.21%] and [(29.85 ± 7.63) frames, (101.38 ± 18.52) frames, (1 669.81 ± 537.61) U/L, (341.68 ± 108.57) U/L, 36.36%, 39.39%], respectively. The above indexes in tirofiban group and nicorandil group were significantly lower than those in control group (n P0.05).n Conclusions:Preoperative intracoronary application of tirofiban or nicorandil is conducive to improving myocardial function and micro-circulation disorders in STEMI patients after PCI, which is of positive roles on improving the short-term prognosis of cardiac function.