Objective To study the effect of tirofiban hydrochloride on the recent prognosis and myocardial markers of ST-elevation acute myocardial infarction (STEMI).Methods A total of 62 patients with STEMI in the People′s Hospital of Yongchuan District of Chongqing from May 2014 to Apr.2015 were collected.According to the sortition method,all the patients were divided into routine treatment group and tirofiban hydrochloride group ,31 cases in each group .Routine treat-ment group was given β-blockers,clopidogrel,aspirin enteric-coated tablets and routine urokinase thrombolysis treatment;tirofiban hydrochloride group was added tirofiban hydrochloride by intravenous infusion on the basis of routine treatment group,pumping speed 0.15 μg/(kg・ min),for 1 to 3 d.Before and after treatment,myocardial markers[creatine kinase MB ( CK-MB ) , troponin I level and enzymatic myocardial infarction area ] and activated partial thromboplastin time ( APTT) ,hemoglobin levels ,platelet count changes of two groups were compared ,and the clinical curative effect ,safety and major adverse cardiac events of two groups were recorded .Results After treatment,the CK-MB,enzymatic myocardial infarction area,troponin I of tirofiban hydrochloride group were significantly lower than those in routine treatment group [(58.0 ±13.0) μg/L,(20 331 ±142) U/L,(13.2 ±2.2) μg/L vs (86.4 ±15.3) μg/L,(26 325 ±231) U/L, (22.4 ±3.0) μg/L](P<0.05).APTT of tirofiban hydrochloride group was significantly longer than routine treatment group[(59.2 ±7.3) s vs (41.0 ±5.3) s,P<0.05],there was no statistically significant difference between platelet and hemoglobin levels of the two groups ( P>0.05 );the total effective rate of tirofiban hydrochloride group was 77.4% ( 24/31),significantly higher than routine treatment group [35.5%(11/31),P<0.05],the curative effect was also significantly higher than routine treatment group ( P<0.05 ) .The incidence of major adverse cardiac events of tirofiban hydrochloride group was 6.4%(2/31),significantly lower than that in routine treatment group[54.8%(17/31)].After treatment,the left ventricular ejection fraction of tirofiban hydrochloride group was (56 ±9)%,it was significantly higher than routine treatment group′s [(43 ±7)%](P<0.05).There were two patients with thrombocytopenia,five patients with bleeding complications in tirofiban hydrochloride group;there were two cases of thrombocytopenia and two cases of bleeding compli-cations in routine treatment group, there was no significantly difference between the two groups [ 22.6%( 7/31 ) vs 12.9%(4/31)](χ2 =0.995,P=0.319).Conclusion Application of tirofiban hydrochloride for treatment STEMI can significantly reduce the myocardial markers ,and improve the recent prognosis with high safety .%目的：探讨盐酸替罗非班对ST段抬高型急性心肌梗死（ STEMI ）近期预后及心肌标志物的影响。方法选取2014年5月至2015年4月重庆市永川区人民医院确诊的62例STEMI患者。按照抽签法将患者分为盐酸替罗非班组和常规治疗组，每组31例。常规治疗组给予β受体阻滞剂、氯吡格雷、阿司匹林肠溶片以及常规尿激酶溶栓治疗等；盐酸替罗非班组在此基础上静脉输注盐酸替罗非班，泵入速度为0．15μg／（kg・ min），持续时间为1～3 d。比较两组患者治疗前后心肌标志物[肌酸激酶同工酶（ CK－MB）、肌钙蛋白I及酶性心肌梗死面积]水平和活化部分凝血活酶时间（ APTT）、血红蛋白水平、血小板计数的变化，记录两组患者的临床疗效、主要心脏不良事件以及安全性。结果治疗后，盐酸替罗非班组患者的肌酸激酶同工酶（ CK－MB）、酶性心肌梗死面积、肌钙蛋白I低于常规治疗组[（58．0±13．0）μg／L、（20331±142） U／L、（13．2±2．2）μg／L比（86．4±15．3）μg／L、（26325±231） U／L、（22．4±3．0）μg／L]（P＜0．05）；盐酸替罗非班组患者的部分凝血活酶时间（APTT）明显长于常规治疗组[（59．2±7．3） s比（41．0±5．3） s]（P＜0．05），血小板及血红蛋白水平比较差异无统计学意义（P＞0．05）；盐酸替罗非班组患者总有效率为77．4％（24／31），显著高于常规治疗组的35．5％（11／31）（ P＜0．05），其疗效也显著高于常规治疗组（ P＜0．05）。盐酸替罗非班组患者的主要心脏不良事件发生率为6．4％（2／31），明显低于常规治疗组[54．8％（17／31）]，治疗后左心室射血分数[（56±9）％]明显高于常规治疗组[（43±7）％]（P＜0．05）。盐酸替罗非班组有2例患者伴有血小板减少，5例患者有出血并发症；常规治疗组血小板减少和出血并发症各2例，两组患者并发症发生率比较差异无统计学意义[22．6％（7／31）比12．9％（4／31）]（χ2＝0．995，P＝0．319）。结论应用盐酸替罗非班治疗STEMI患者能明显降低患者心肌标志物水平，改善近期预后且安全性高。
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