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目的 :探讨急诊PCI应用前列地尔脂微球载体制剂(凯时)对急性心肌梗死再灌注的影响。方法 :选择2012年2月~2014年10月本院行急诊PCI的急性ST段抬高心肌梗死患者100例,随机分为对照组和试验组,每组各50例,对照组给予替罗非班500μg导管内注入,试验组在应用替罗非班的基础上,术中冠脉内给予替罗非班+前列地尔,术前开始用前列地尔静脉滴注(20μg/次,2次/d)至术后48h。结果 :试验组TMPG3级血流比例明显高于对照组,试验组单导ST段回落指数高于对照组,两组差异有统计学意义。结论 :前列地尔可有效改善急性ST段抬高心肌梗死(AMI)后心肌再灌注,降低住院期间心血管事件的发生率,出血及心脏不良事件的发生无增加,值得在临床上推广使用。
Objective: To investigate the effect of emergency PCI on the reperfusion of acute myocardial infarction (AMI). Methods: From February 2012 to October 2014, 100 patients with acute ST-segment elevation myocardial infarction who underwent emergency PCI in our hospital were randomly divided into control group and trial group, 50 cases in each group. The control group was given tirofiban 500μg intraperitoneal injection, the experimental group in the application of tirofiban on the basis of intracoronary administration of tirofiban + alprostadil, preoperative alprostadil infusion (20μg / times, 2 times / d) to 48h after surgery. Results: The proportion of TMPG3 grade blood flow in the experimental group was significantly higher than that in the control group. The drop index of ST segment in the experimental group was higher than that in the control group. There was significant difference between the two groups. Conclusion: Alprostadil is effective in improving myocardial reperfusion after acute ST-segment elevation myocardial infarction (AMI) and reducing the incidence of cardiovascular events during hospitalization. There is no increase in bleeding and cardiac adverse events. It is worth to be used clinically.