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2型糖尿病而发生急性前壁心肌梗死患者68例,年龄45~76(60.8±8.5)岁,随机分为替罗非班治疗组(n=34)和对照组(n=34),治疗组在介入术前常规给予阿司匹林、氯吡格雷、阿托伐他汀等治疗,同时静脉加用盐酸替罗非班,以输液泵持续泵入;对照组除未加替罗非班外,其他治疗同治疗组。观察两组术中再灌注血管终末段显影祯数和术后90m in内ST段回落情况、肌酸激酶同工酶(CK-MB)酶峰时间,术中及术后重要脏器出血情况、心衰发生率、术后1周心功能情况。结果两组靶血管经皮冠状动脉介入(PC I)成功率均达100%,术中及术后出血事件、心衰、病死率差异无显著性;治疗组术后再灌注血管终末段显影祯数和术后90 m in内ST段回落情况均优于对照组(P<0.05),术后治疗组CK-MB酶峰时间较对照组提前(P<0.05);1周后心脏彩超评价心脏左室射血分数(LVEF)差别无显著性。结论急诊介入治疗早期联合应用替罗非班安全、有效,能改善冠脉微循环及心肌灌注。
Sixty-eight patients with acute anterior myocardial infarction who were type 2 diabetic and aged 45-76 years (60.8 ± 8.5 years) were randomly assigned to tirofiban treatment group (n = 34) and control group (n = 34) In the preoperative interventional routine given aspirin, clopidogrel, atorvastatin and other treatment, while intravenous plus tirofiban hydrochloride, continuous infusion pump; control group except without Tirofiban, other treatment with therapy group. The number of intra-arterial reperfusion vessels and the fall of ST segment within 90 mins after the operation were observed. The peak time of creatine kinase isozyme (CK-MB), intraoperative and postoperative bleeding of major organs , The incidence of heart failure, cardiac function after 1 week. Results The successful rates of percutaneous coronary intervention (PC I) in both groups reached 100%, there was no significant difference in intraoperative and postoperative bleeding, heart failure and case fatality rate. In the treatment group, the final vessel reperfusion (P <0.05). The CK-MBase peak time of the postoperative treatment group was earlier than that of the control group (P <0.05). After 1 week, the cardiac color Doppler echocardiography Cardiac left ventricular ejection fraction (LVEF) was no significant difference. Conclusion Early intervention with Tirofiban is safe and effective in the treatment of coronary microcirculation and myocardial perfusion.