张立伟

【摘要】 目的：对比分析急性心肌梗死患者急诊经皮冠状动脉介入治疗时不同时机使用替罗非班的效果。方法：选取近期在本院接受治疗的90例急性心肌梗死患者作为研究对象，按照随机数字表法分为试验1组、试验2组和对照组，每组30例。所有患者均接受急诊PCI治疗，对照组不给予替罗非班，试验1组PCI术前给予替罗非班，试验2组PCI术完成后即刻静脉泵入替罗非班。比较三组治疗后血流再通情况、LVESD、LVEDD以及NT-proBNP、CTNT、CK-MB变化以及治疗期间不良心脏事件情况。结果：治疗后，试验1、2组TIMI血流分级3级率均显著高于对照组，2级率均显著低于对照组，差异均有统计学意义（P<0.05）;试验1组3级率显著高于试验2组，差异有统计学意义（P<0.05）。治疗后，试验1、2组cTnT、CK-MB均低于对照组，差异均有统计学意义（P<0.05）;试验1组cTnT、CK-MB均低于试验2组，差异均有统计学意义（P<0.05）。治疗后，试验1、2组LVEF高于對照组，LVESD、LVEDD及NT-proBNP均低于对照组，差异均有统计学意义（P<0.05）。三组不良心脏事件发生率比较，差异无统计学意义（P>0.05）。结论：急性心肌梗死患者急诊PCI治疗时应用替罗非班治疗效果显著，且最佳给药时间为PCI术前给药。

【关键词】 急性心肌梗死 急诊经皮冠脉介入 替罗非班 不同时机

Effect of Tirofiban Used at Different Timing on Patients with Acute Myocardial Infarction Undergoing Emergency Percutaneous Coronary Intervention/ZHANG Liwei. //Medical Innovation of China， 2021， 18（28）： -150

[Abstract] Objective： To compare and analyze the effect of Tirofiban used at different timing in patients with acute myocardial infarction underwent emergency percutaneous coronary intervention. Method： Ninety patients with acute myocardial infarction who recently received treatment in our hospital were selected as the research objects， and they were divided into the experimental 1 group， the experimental 2 group and the control group according to the random number table method， 30 cases in each group. All patients received emergency PCI treatment， the control group was not given Tirofiban， the experimental 1 group was given Tirofiban before PCI， and the experimental 2 group was given intravenous Tirofiban immediately after PCI operation completed. The blood flow recanalization， LVESD， LVEDD， NT-proBNP， cTnT， CK-MB and adverse cardiac events during treatment among three groups were compared. Result： After treatment， the rate of TIMI blood flow grade 3 in the experimental 1 and 2 group were significantly higher than that in the control group， and the rates of grade 2 were significantly lower than that in the control group， and the differences were statistically significant （P<0.05）; the rate of grade 3 in the experimental 1 group was significantly higher than that in the experimental 2 group， the difference was statistically significant （P<0.05）. After treatment， the cTnT and CK-MB in the experimental 1 and 2 group were lower than those in the control group， and the differences were statistically significant （P<0.05）; the cTnT and CK-MB in the experimental 1 group were lower than those in the experimental 2 group， and the differences were statistically significant significance （P<0.05）. After treatment， the LVEF of the experimental 1 and 2 group were higher than that of the control group， and LVESD， LVEDD and NT-proBNP were lower than those of the control group， and the differences were statistically significant （P<0.05）. There was no significant difference in the incidence of adverse cardiac events among three groups （P>0.05）. Conclusion： Tirofiban is effective in patients with acute myocardial infarction undergoing emergency PCI， and the best time of administration is before PCI.

[Key words] Acute myocardial infarction Emergency percutaneous coronary intervention Tirofiban Different timing

First-author’s address： Huludao Central Hospital， Huludao 125000， China

doi：10.3969/j.issn.1674-4985.2021.28.036

急性心肌梗死是常发于老年人的一种临床急症，其主要原因是冠状动脉异常，导致心肌坏死，该病具有发病急、致死率高的特点，使患者的生命安全受到较大影响[1]。临床资料表明：急性心肌梗死患者大部分死亡的主要原因是疾病引发的严重并发症，如心脏破裂导致的心源性休克、急性左心衰、心律失常等[2]。……