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目的探讨替罗非班在急性ST段抬高心肌梗死患者急诊介入术中的应用效果。方法选取2013年1月—2014年2月襄城县人民医院收治的急性ST段抬高心肌梗死患者100例,采用随机数字表法分为观察组和对照组,各50例。两组患者术前均采用常规药物治疗,观察组患者在此基础上加用替罗非班治疗,比较两组患者心肌梗死溶栓试验(TIMI)血流分级、心肌灌注分级(TMPG),梗死相关血管(IRA)自溶、ST段回落>50%、术中无复流发生率,穿刺点出血、非致死性心肌梗死和心源性死亡等心血管不良事件发生率。结果观察组患者TIMI血流分级、TMPG均优于对照组(u=-2.113、-2.426,P=0.034、0.015),IRA自溶、ST段回落>50%发生率均高于对照组,术中无复流、心血管不良事件发生率均低于对照组(P<0.05)。结论急诊介入术中应用替罗非班可有效改善急性ST段抬高心肌梗死患者心肌血液灌注,有效促进微循环恢复,改善患者预后,减少心血管不良事件的发生。
Objective To investigate the effect of tirofiban in emergency interventional treatment of patients with acute ST-segment elevation myocardial infarction. Methods From January 2013 to February 2014, 100 patients with acute ST-segment elevation myocardial infarction admitted to Xiangcheng People’s Hospital were randomly divided into observation group and control group with 50 cases in each group. The patients in both groups were given conventional tirofiban preoperatively. Tirofiban was used to treat the patients in the two groups. The TIMI flow classification, myocardial perfusion grading (TMPG), infarction Related blood vessels (IRA) autolysis, ST segment regression> 50%, intraoperative no-reflow incidence, puncture point bleeding, non-fatal myocardial infarction and cardiovascular mortality and other cardiovascular adverse events. Results The TIMI grade and TMPG in observation group were better than that in control group (u = -2.113, -2.426, P = 0.034,0.015), IRA autolysis and ST segment regression> 50% No-reflow, cardiovascular adverse events were lower than the control group (P <0.05). Conclusion The application of tirofiban in emergency intervention can effectively improve myocardial blood perfusion in patients with acute ST-segment elevation myocardial infarction, effectively promote the recovery of microcirculation, improve the prognosis of patients and reduce the occurrence of cardiovascular adverse events.