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目的探讨替罗非班不同给药方式对急性ST段抬高型心肌梗死(STEMI)患者急诊冠脉介入治疗(PCI)临床效果的影响。方法选择STEMI行急诊PCI患者96例,随机分为A组27例、B组39例、C组30例。三组均行急诊PCI、血栓抽吸术联合替罗非班治疗,A组替罗非班静脉注射,B组替罗非班普通冠脉口注射,C组替罗非班改良冠脉注射。比较三组住院期间再灌注心律失常发生率、校正TIMI帧数(CTFC)、心肌染色分级(MBG)、术后24h血肌钙蛋白I(c Tn I)峰值以及出院后1个月行心脏超声检查左室射血分数(LVEF)、左室舒张末期内径(LVEDD),记录住院及随访期间主要不良心血管事件(MACE)发生情况。结果 C组再灌注心律失常发生率、CTFC、c Tn I低于A、B组(P均<0.05),MBG、LVEF、LVEDD高于A、B组(P均<0.05)。出院1个月后随访,三组均未出现新发心肌梗死及再次血运重建等MACE。结论替罗非班改良冠脉注射对STEMI患者急诊PCI效果优于传统的静脉注射及普通冠脉口注射。
Objective To investigate the effect of different administration of tirofiban on the clinical effect of emergency percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods 96 STEMI patients with acute PCI were selected and randomly divided into group A (n = 27), group B (n = 39) and group C (n = 30). Three groups were performed emergency PCI, thrombectomy combined with tirofiban treatment, A group of Tirofiban intravenous injection, B group Triclofiban ordinary coronary injection, C group Tirofiban improved coronary injection. The incidences of reperfusion arrhythmia, corrected TIMI frames (CTFC), myocardial grading (MBG), peak value of cTnI after operation and cardiac ultrasonography Left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVEDD) were examined. The incidence of major adverse cardiovascular events (MACE) during hospitalization and follow-up were recorded. Results The incidence of reperfusion arrhythmia in group C was lower than that in group A and B (P <0.05). The levels of MBG, LVEF and LVEDD in group C were higher than those in group A and B (all P <0.05). One month after discharge, follow-up showed no new myocardial infarction and revascularization in all three groups. Conclusion Tilapifil improved coronary injection in patients with STEMI emergency PCI better than traditional intravenous injection and ordinary coronary injection.