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目的观察盐酸替罗非班在急性 ST 段抬高型心肌梗死患者急诊介入治疗术中的疗效和安全性。方法 58例急性 ST 段抬高型心肌梗死患者随机分为2组,其中盐酸替罗非班(欣维宁)组30例,对照组28例,均于发病12 h 内行急诊经皮冠状动脉介入治疗术(PCI)。盐酸替罗非班(欣维宁)组 PCI 术中即刻静脉予负荷量0.4μg/kg·min~(-1)×30 min,维持量0.15μg/kg·min~(-1)×36 h。两组患者 PCI 术中均给予肝素8 000～10 000 U。PCI术前服用氯吡格雷300 mg,阿司匹林300 mg,术后各75 mg/d,观察 PCI 术前、术后梗死相关血管 TIMI 血流情况、术后4周内并发症及主要不良心脏事件的发生情况。结果盐酸替罗非班组 PCI 术后慢复流发生率及主要不良心脏事件的发生率均低于对照组,差异有统计学意义。出血并发症的发生率高于对照组,差异无统计学意义。结论盐酸替罗非班能改善急性心肌梗死患者 PCI 术后梗死相关血管的 TIMI 血流,减少 PCI 术后主要不良心脏事件的发生率,临床应用安全有效。
Objective To observe the efficacy and safety of tirofiban hydrochloride in emergency interventional treatment of patients with acute ST-segment elevation myocardial infarction. Methods Fifty-eight patients with acute ST-elevation myocardial infarction were randomly divided into two groups, including 30 patients in tirofiban hydrochloride group and 28 patients in control group. All patients underwent emergency percutaneous coronary intervention Treatment (PCI). The patients in the tirofiban hydrochloride group received immediate intravenous administration of 0.4 μg / kg · min -1 for 30 min with a maintenance dose of 0.15 μg / kg · min -1 × 36 h . Heparin was given between 8 000 and 10 000 U in both groups. PCI preoperative clopidogrel 300 mg, aspirin 300 mg, postoperative 75 mg / d, observed before PCI, postoperative infarction-related vascular TIMI blood flow within 4 weeks after the complications and major adverse cardiac events What happened? Results The incidence of postoperative slow reflow and the incidence of major adverse cardiac events after tirofib hydrochloride treatment were lower than those of the control group, the difference was statistically significant. The incidence of bleeding complications than the control group, the difference was not statistically significant. Conclusion Tirofiban hydrochloride can improve the TIMI blood flow of infarction-related blood vessels in patients with acute myocardial infarction and reduce the incidence of major adverse cardiac events after PCI. The clinical application is safe and effective.