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【目的】探讨替罗非班不同给药途径对急性心肌梗死患者临床疗效。【方法】选择本院2011年1月至2014年7月行急诊经皮冠状动脉介入术（PCI）的急性ST段抬高型心肌梗死患者180例，按照给药途径不同分为冠脉组（64例）、静脉组（60例）和未给替罗非班的常规组（56例），比较三组术后血流分级、心电图ST段回落率、磷酸肌酸激酶同工酶（CK‐MB）水平、住院期间和随访6～9月主要心血管不良事件（MACE）及出血并发症等不良反应。【结果】冠脉组和静脉组较常规组术后血流情况明显改善（ P ＜0．05），心电图ST段回落率和CK‐MB水平均显著优于常规组（ P ＜0．05），三组间MACE及出血等不良反应发生率无统计学差异（ P ＞0．05）。【结论】行急诊PCI的急性ST段抬高型心肌梗死患者应用盐酸替罗非班可以改善冠状动脉血流，不增加出血风险，但不能改善M ACE发生率。“,”[Objective] To compare the efficacies of intracoronary ,intravenous or without tirofiban injec‐tion in patients with acute myocardial infarction (AMI) undergoing emergency percutaneous coronary artery in‐tervention (PCI) .[Methods] A total of 90 AMI patients undergoing emergency PCI were divided into three groups of coronary artery ( n =64) ,peripheral vein ( n = 60) and general treatment ( n = 56) .The TIMI grades of forward blood flow in target vessels ,ST‐segment resolution ,cardiac markers ,incidence of major ad‐verse cardiac events (M ACE) in hospital during a follow‐up of 6~9 months and incidence of bleeding events were observed after PCI .[Results] The TIMI blood grade of coronary artery group ( P=0 .012) and periph‐eral vein group ( P =0 .017) improved more than that of general treatment group .The incidences of MACE and all‐cause mortality in three groups were not statistically different ( P = 0 .24) .No serious bleeding oc‐curred in three groups while slight bleeding complications occurred in three groups .However ,there were no statistical differences ( P =0 .043) .[Conclusion] The dosing of tirofiban by coronary artery or vein is effec‐tive in enhancing blood fIow but fails to improve the prognosis after PCI in AMI .