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目的分析急性ST段抬高型心肌梗死(STEMI)患者早期应用不同剂量替罗非班对行急诊PCI后血小板聚集功能及活性的影响。方法采用随机数字表法将117例急性STEMI行急诊PCI患者进行分组,常规剂量组58例给予1~3 min内静脉推注替罗非班10μg/kg,大剂量组59例给予1~3 min内静脉推注替罗非班25μg/kg。观察两组治疗前后血小板凝聚功能抑制率(IPA)、血小板活性指标变化和药物安全性。结果大剂量组静脉泵入10 min末、静脉泵入24 h末和停药24 h末血小板凝聚功能抑制率明显高于常规剂量组(P<0.01);大剂量组静脉泵入10 min末血小板活性明显低于常规剂量组(P<0.01);大剂量组不良反应发生率(14.29%)明显低于常规剂量组(33.33%),P<0.05。结论急诊STEMI患者行急诊PCI后早期应用大剂量替罗非班(25μg/kg)能够显著提高血小板凝聚功能抑制率和降低血小板活性,安全可靠,在改善血流再灌注和心肌微循环灌注方面具有非常重要作用。
Objective To analyze the effect of different doses of Tirofiban on platelet aggregation and activity after acute PCI in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods A total of 117 acute STEMI patients undergoing PCI were divided into two groups according to a random number table. 58 patients in the conventional dose group received intravenous tirofiban 10 μg / kg within 1 ~ 3 min, and 59 patients in the high dose group received 1 ~ 3 min Intravenous tirofiban 25μg / kg. The inhibition of platelet aggregation (IPA), changes of platelet activity and drug safety before and after treatment were observed. Results In the high-dose group, the inhibition rate of platelet aggregation at the end of 24 h and 24 h after intravenous injection was significantly higher than that of the conventional dose group (P <0.01) (P <0.01). The incidence of adverse reactions in high dose group (14.29%) was significantly lower than that in conventional dose group (33.33%), P <0.05. Conclusions Early use of high dose tirofiban (25μg / kg) after emergency PCI in emergency STEMI patients can significantly increase the inhibitory rate of platelet aggregation and reduce platelet activity, which is safe and reliable, and has the advantages of improving blood flow reperfusion and myocardial microcirculation perfusion Very important role.