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目的评价急性ST段抬高性心肌梗死(STEMI)在急诊冠状动脉介入治疗时血栓抽吸导管联合替罗非班的有效性及安全性。方法将63例STEMI患者随机分为血栓抽吸+替罗非班组(观察组)和标准经皮冠状动脉介入治疗组(对照组)。观察两组术后TIMI血流、心电图ST段回落>50%、左室舒张末期内径(LVDd)、左室射血分数(LVEF)及术后4周主要心血管事件和出血并发症。结果观察组TIMI3级血流、心电图ST段回落>50%的发生率及LVEF高于对照组,心肌酶达峰时间和LVDd低于对照组(P<0.05)。两组患者住院期间主要心血管事件和出血发生率比较差异无统计学意义(P>0.05)。结论血栓抽吸导管联合替罗非班治疗急性ST段抬高性心肌梗死有效且安全性较好。
Objective To evaluate the efficacy and safety of thrombus aspiration catheter combined with tirofiban in acute ST-segment elevation myocardial infarction (STEMI) during emergency percutaneous coronary intervention. Methods Sixty-three patients with STEMI were randomly divided into thrombolysis + tirofiban group (observation group) and standard percutaneous coronary intervention group (control group). The postoperative TIMI blood flow, ST-segment depression> 50%, left ventricular end-diastolic diameter (LVDd), left ventricular ejection fraction (LVEF) and major cardiovascular events and bleeding complications after 4 weeks were observed. Results The TIMI grade 3 blood flow, ST-segment depression> 50% and LVEF in the observation group were higher than those in the control group. The peak time of myocardial enzymes and LVDd in the observation group were lower than those in the control group (P <0.05). There were no significant differences in the incidence of major cardiovascular events and bleeding between the two groups during hospitalization (P> 0.05). Conclusion Thrombus aspiration catheter combined with tirofiban in the treatment of acute ST-segment elevation myocardial infarction is effective and safe.