盐酸替罗非班在急性心肌梗死冠脉介入治疗中的临床研究

摘要

目的 评价血小板膜糖蛋白Ⅱb/Ⅲa受体拮抗剂盐酸替罗非班在急性心肌梗死(AMI)患者急诊冠状动脉介入治疗(PCI)中的治疗效果.方法 将82例AMI患者随机分为对照组(直接PCI,42例)和替罗非班组(替罗非班+PCI,40例),比较两组患者梗死相关动脉PCI后即刻TIMI血流,术后12、24h肌酸激酶同工酶变化,术后2周左室射血分数,术后30d内不良心脏事件(心绞痛、心肌梗死、死亡)及出血和血小板减少的发生率.结果 两组基础临床情况和冠状动脉造影特征无明显差异(P＞0.05),替罗非班组梗死相关动脉PCI术后即刻TIMI血流高于对照组(P＜0.05),替罗非班组轻度出血发生率高于对照组,但未发生严重出血和血小板减少症.术后2周左室射血分数,术后12、24h肌酸激酶同工酶变化与对照组相比差异无统计学意义(P＞0.05).结论 盐酸替罗非班在急诊PCI治疗中是有效而安全的,值得在临床推广应用.%Objective The study aims to evaluate the treatment effect of GP II b/ III a receptor antagonists tirofiban hydrochloride in primary percutaneous coronary intervention (PCI) for patients with acute myocardial infarction (AMI). Methods The AMI patients (n=82) were divided into 2 groups- the control group (PCI only, n=42) and the tirofiban group (tirofiban+PCI, n = 40). After PCI, the TIMI flow of related coronary artery immediately, the plasma level of CK-MB at 12h and 24h, the left ventricular ejection fraction at 2 week, and the major adverse cardiac events (unstable angina, myocardial infarction and death) and the incidence of hemorrhage and thrombocytopenia at 30 day were detected. Results Compared to the control group, the TIMI flow and the incidence of hemorrhage was high(P<0. 05), but no serious hemorrhage and thrombocytopenia happened. There were no significant difference of CK-MB level between the two groups(P>0. 05). Conclusion It iseffective and safe to use tirofiban hydrochloride in primary PCI for patients with AMI.