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目的:探讨老年患者发生急性ST段抬高心肌梗死(acute myocardial infarction with ST segment elevation,STEMI)后,在急诊经皮冠状动脉介入治疗(percutaneuos coronary intervention,PCI)前应用国产替罗非班的有效性和安全性。方法:入选连续收治并成功行急诊PCI的98例老年STEMI患者,随机分为术前应用替罗非班组46例,对照组(未应用替罗非班)52例,比较两组用药后24h、30天及术后6个月心血管事件及出血并发症。结果:术后替罗非班组与穿刺有关并发症9例,对照组7例,替罗非班组多于对照组,但二者差异无统计学意义(P=0.415);术后1个月及6个月两组EF无差异(P>0.05);术后1个月替罗非班组心血管事件3例,对照组11例(P=0.039),术后6个月替罗非班组心血管事件4例,对照组13例(P=0.046)。结论:急诊PCI前应用国产替罗非班治疗老年STEMI的患者安全有效,能降低术后1个月及6个月内心血管事件,不增加出血事件。
Objective: To investigate the effect of domestic tirofiban before emergency percutaneous coronary intervention (PCI) in elderly patients with acute myocardial infarction with ST segment elevation (STEMI) Sexuality and safety. Methods: A total of 98 elderly patients with STEMI who underwent consecutive PCI and were successfully treated with PCI were randomly divided into preoperative application of tirofiban in 46 cases and control group (no tirofiban used) in 52 cases. After 24 hours of treatment, 30-day and 6-month postoperative cardiovascular events and bleeding complications. Results: Tilofiban group had 9 cases of complications related to puncture and 7 cases of control group. Tirofiban group had more complications than control group, but there was no significant difference between the two groups (P = 0.415) There was no difference in EF between the two groups at 6 months (P> 0.05). One month after operation, cardiovascular events in two groups were compared with those in control group (n = 11) (P = 0.039) 4 cases, control group, 13 cases (P = 0.046). Conclusion: It is safe and effective to treat patients with STEMI in elderly patients before emergency PCI, which can reduce the cardiovascular events within 1 month and 6 months after operation without increasing the bleeding rate.