目的 探讨小剂量替罗非班用于青中年急性心肌梗死(AMI)溶栓治疗的效果及安全性.方法 选取120例AMI患者,按照随机数字表法分成A组和B组.A组给予瑞替普酶联合小剂量替罗非班[0.05 μg/(kg·min)]静滴维持,B组给予瑞替普酶联合常规剂量替罗非班[0.1 μg/(kg·min)]静滴维持.比较2组的血管再通率、血小板聚集率、凝血和纤溶相关指标水平、主要临床事件及出血并发症发生情况.结果 A组的血管再通率为76.67%,与B组的81.67%比较无显著差异(P>0.05);2组治疗后的血小板聚集率较治疗前均显著下降(P<0.05);2组治疗后的Fg和D-D指标水平显著下降,PLT和t-PA指标水平显著升高(P<0.05);治疗1个月后,2组主要临床事件发生率无显著差异(P>0.05);A组的出血并发症总发生率显著低于B组(P<0.05).结论 小剂量替罗非班治疗AMI的溶栓效果与常规剂量相近,但出血并发症较少,安全性较高.%Objective To investigate the efficacy and safety of low dose tirofiban combined with reteplase in the thrombolytic treatment of young and middle-aged patients with acute myocardial infarction (AMI).Methods A total of 120 AMI patients were selected and randomly divided into group A and group B,60 cases in each group.The patients in the group A were given reteplase combined with low dose of tirofiban [0.05 μg/(kg·min)],and the patients in the group B were given reteplase combined with routine dose of tirofiban [0.1 μg/(kg·min)].The vascular recanalization rate,the platelet aggregation rate,the levels of coagulation and fibrinolysis related indicators,the main clinical events and bleeding complications were compared between two groups.Results The vascular recanalization rate of group A was 76.67%,which was similar to 81.67% of group B (P>0.05).After treatment,the platelet aggregation rate were significantly lower than that before treatment in both groups (P<0.05).After treatment,the levels of Fg and D-D were significantly lower than those before treatment in both groups,and the levels of PLT and t-PA were significantly higher than those before treatment (P<0.05).After one month of treatment,there was no significant difference in incidence rate of clinical events between two groups (P>0.05).The incidence rate of bleeding complications in group A was significantly lower than the group B (P<0.05).Conclusion The thrombolytic effect of low dose tirofiban on treatment of AMI is similar to that of the conventional dose,but it can reduce the risk of bleeding and improve medication safety.
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