廖然 韩青 何华斌

摘 要 目的：分析替罗非班不同给药途径治疗急性心肌梗死的疗效。方法：选取急性心肌梗死患者67例作为研究对象，开展回顾性治疗研究。患者均行PCI治疗，根据患者术中替罗非班给药途径进行分组，其中静脉组34例，冠脉组33例。静脉组术中行替罗非班静脉注射给药，冠脉组术前行冠状动脉注射给药。对比两组的临床疗效，3级血流、心肌灌注3级占比，心室功能指标及不良事件发生率。结果：冠脉组治疗后左室舒张末、收缩末内径较静脉组降低明显，左室射血分数提升显著；冠脉组治疗后心脏不良事件发生率低于静脉组（P<0.05）。结论：冠状动脉注射给药治疗急性心肌梗死的效果优于静脉注射给药。

关键词 替罗非班 静脉给药 冠状动脉给药 急性心肌梗死

中图分类号：R973.2； R542.22 文献标志码：B 文章编号：1006-1533（2021）07-0029-03

Efficacy of different administration routes of tirofiban in the treatment of acute myocardial infarction

LIAO Ran， HAN Qing， HE Huabin（the First Department of Cardiovascular Medicine， the First Peoples Hospital of Jiujiang City， Jiangxi Jiujiang 332000， China）

ABSTRACT Objective： To analyze the efficacy of different administration routes of tirofiban in the treatment of acute myocardial infarction. Methods： A total of 67 patients with acute myocardial infarction were selected as the research subjects， and the retrospective treatment studies were carried out. All the patients underwent PCI and were divided into a vein group （34 cases， giving intravenous tirofiban injection） and a coronary artery group （33 cases， giving coronary artery tirofiban injection） based on their tirofiban administration routes. The clinical efficacy， the proportion of grade 3 blood flow and myocardial perfusion grade 3， the ventricular function indexes and the incidence of adverse events were compared. Results： The left ventricular end diastolic and end systolic diameters were decreased， the left ventricular ejection fraction was significantly increased in the coronary artery group and the incidence of cardiac adverse events was significantly lower in the coronary artery group than the vein group after treatment （P<0.05）. Conclusion： The efficacy of tirofiban by coronary artery injection is much better than intravenous injection in the treatment of acute myocardial infarction.

KEy WORDS tirofiban； intravenous administration； coronary administration； acute myocardial infarction

經皮冠脉介入手术（percutaneous coronary intervention，PCI）是急性心肌梗死的主要治疗手段，但术后仍存在一定支架内血栓形成的风险，导致心脏不良事件的发生，故需在术中通过血小板拮抗药物联合应用，改善手术预后。有研究指出，替罗非班这一常用血小板拮抗药物治疗效果可由不同给药路径造成差异[1]。

1 资料与方法

1.1 一般资料

选取2017年6月—2019年7月九江市第一人民医院收治的急性心肌梗死患者67例作为研究对象。患者入院后均行PCI治疗，根据患者术中替罗非班的给药途径分为静脉组34例和冠脉组33例。其中静脉组男18例，女16例；年龄52～75岁，平均年龄（63.51±4.55）岁；发病至就医时间4～6 h，平均时间（5.24±0.35） h；手术后确认前壁梗死19例，非前壁梗死15例。冠脉组男17例，女16例；年龄54～74岁，平均年龄（64.05±4.68）岁；发病至就医时间4～5.8 h，平均时间（4.91±0.29） h；……