目的探讨小剂量替罗非班对急性心肌梗死(AMI)患者急诊经皮冠状动脉介入治疗(PCI)术后支架内血栓形成及血清白介素6(IL-6)、血管性血友病因子(vWF)水平的影响。方法选取2015年在惠州市第一人民医院行急诊PCI的AMI患者60例,采用随机数字表法分为对照组和观察组,每组30例。两组患者入院后均给予阿司匹林和氯吡格雷治疗,术后持续服用9~12个月;观察组患者在此基础上于PCI术前5~10 min静脉滴注替罗非班4~5μg/kg,之后0.050~0.075μg·kg~(-1)·min~(-1)维持36~48 h。比较两组患者术前24 h及术后48 h血清IL-6、vWF水平,术后支架内血栓形成发生率,不良反应发生情况,随访1年不良心脏事件发生率,术前及随访1年生活质量评分。结果术前两组患者血清IL-6、vWF水平比较,差异无统计学意义(P>0.05);术后观察组患者血清IL-6、vWF水平低于对照组(P<0.05)。术后两组患者支架内血栓形成发生率比较,差异无统计学意义(P>0.05)。两组患者治疗过程中血小板减少症、严重出血及轻微出血发生率比较,差异无统计学意义(P>0.05)。两组患者术后1年不良心脏事件发生率比较,差异无统计学意义(P>0.05)。术前两组患者简明健康状况调查量表(SF-36)生活功能评分、社会功能评分、精神状态评分、健康状况评分、情感职能评分比较,差异无统计学意义(P>0.05);术后1年观察组患者SF-36生活功能评分、社会功能评分、精神状态评分、健康状况评分、情感职能评分高于对照组(P<0.05)。结论小剂量替罗非班有利于降低AMI患者急诊PCI术后血清IL-6、vWF水平,改善患者生活质量,不良反应较少,但其对支架内血栓形成及不良心脏事件等无明显影响。 Objective To investigate the effects of low dose tirofiban on thrombosis and serum levels of interleukin 6 (IL 6), von Willebrand factor (vWF) in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI) ) Level of influence. Methods Sixty patients with AMI who underwent emergency PCI in Huizhou First People’s Hospital in 2015 were randomly divided into control group and observation group with 30 cases in each group. Both groups were given aspirin and clopidogrel after admission and continued to take for 9 to 12 months after operation. The patients in the observation group were treated with intravenous infusion of tirofiban 4-5 μg / kg, then maintained for 36-48 h at 0.050-0.075 μg · kg -1 (-1) min -1. The levels of serum IL-6 and vWF, the incidence of thrombosis after stent thrombosis and the incidence of adverse reactions at 24 and 48 h after operation were compared between the two groups. The incidence of adverse cardiac events at 1-year follow-up and the follow-up of 1 year Quality of life score. Results There was no significant difference in the serum levels of IL-6 and vWF between the two groups before operation (P> 0.05). The levels of IL-6 and vWF in the postoperative observation group were lower than those in the control group (P <0.05). There was no significant difference in the incidence of stent thrombosis between the two groups (P> 0.05). There was no significant difference between the two groups in the incidence of thrombocytopenia, severe bleeding and mild bleeding during treatment (P> 0.05). There was no significant difference between the two groups in incidence of adverse cardiac events one year after operation (P> 0.05). There were no significant differences in SF-36 functional status, social function score, mental status score, health status score and emotional function score between the two groups before surgery (P> 0.05) SF-36 life function score, social function score, mental status score, health status score and emotional function score in the 1-year observation group were higher than those in the control group (P <0.05). Conclusion Low dose tirofiban can reduce the levels of IL-6 and vWF in patients with acute myocardial infarction after AMI and improve the quality of life of patients with less adverse reactions. However, it has no significant effect on thrombosis and adverse cardiac events in patients with AMI.