替罗非班在急性心肌梗死介入治疗术后的临床疗效及安全性研究(1)
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【摘要】 目的 观察替罗非班在急性心肌梗死患者介入治疗术后的临床疗效及安全性。方法 急性心肌梗死患者106例,均于发病后6 h之内行急诊介入治疗,随机分为替罗非班组(n=52)和对照组(n=54)。所有患者均口服阿司匹林、氯吡格雷、皮下注射低分子肝素。替罗非班组在对照组治疗基础上于介入术后1 h内开始应用替罗非班,持续泵入至术后36 h。观察两组患者的心电图、左室射血分数变化以及主要不良心脏事件、不良反应的发生情况。结果 治疗后两组心电图均有明显改善,替罗非班组与对照组比较有较高的sumSTR>70%(P<0.05)。替罗非班组左室射血分数明显高于对照组,不良心脏事件发生率低于对照组(P<0.05),出血的发生率两组间比较差异无统计学意义(P>0.05)。结论 急性心肌梗死患者介入治疗术后使用替罗非班可减少术后心源性死亡、再次心肌梗死、靶血管再次血运重建的发生,改善心脏功能,同时不增加出血风险,为安全有效的治疗方法。
【关键词】 替罗非班;急性心肌梗死;介入治疗
Safety and effect of Tirofiban in patients with acute myocardial infarction treated with percutaneous coronary intervention
YU Xiang,LU Chen zhi,CAI Lin,et al.The fist central hospital of Tianjin,Tianjin 100053,China
【Abstract】 Objective To evaluate the safety and efficacy of Tirofiban in patients with acute myocardial infarction treated with percutaneous coronary intervention.Methods 106 acute myocardial infarction patients treated with percutaneous coronary intervention (PCI) were randomly divided into Tirofiban group (n=52) and control group(n=54).All patients took aspirin,clopidogrel and injected heparin subcutaneously.In the Tirofiban group,the drug was used within 1 hour after PCI for 36 hours.ECG,left ventricular ejection fraction (LVEF),major adverse cardiac events(MACE) and hemorrhagic incidents were observed.Results The myocardial ischemia improved in two groups,and for the Tirofiban group,there were more patients got the optimal sum STR> 70 % (P<0.05).Comparing with the control group,the Tirofiban group had higher LVEF and lower MACE incidence (P<0.05).There was no significant difference of bleeding incidence between the two groups (P>0.05).Conclusion Using Tirofiban after PCI in AMI patients,being safety and efficacy,can decrease the incidences of cardiac death,re infarction and target vessel revascularization and improve the heart function,at the same time,dose not increase the risk of bleeding.
【Key words】 Tirofiban;Acute myocardial infarction;Percutaneous coronary intervention
急性心肌梗死(AMI)的主要发病机制是冠状动脉内粥样斑块破裂,血小板活化聚集,血小板血栓形成,有效的抗凝、抗血小板辅助治疗能显著改善微循环状态,减轻心肌细胞缺血性损伤程度,从而进一步改善急性心肌梗死患者经皮冠状动脉介入术(PCI)术后左室功能和临床预后[1,2] ......
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