目的 探究并分析不同时机给予替罗非班对急性心肌梗死患者介入术(PCI)后冠脉血流以及并发症的影响.方法 选取90例需行PCI手术的ST段抬高急性心肌梗死患者,按照随机数字表法将其分为观察组和对照组.对照组在PCI术中给予替罗非班,观察组PCI术前给予替罗非班.观察并记录TIMI血流、校正TIMI帧数计数(CT-FC)、90 min ST段回落百分比、术后心血管事件发生率以及并发症发生率.结果 观察组CTFC、90 min内ST回落较对照组改善更明显(P<0.05).2组术前TIMI血流分级比较差异无统计学意义(P>0.05).经秩和检验,2组术后TIMI血流0~1级、2级、3级人数比较差异有统计学意义(P<0.05).2组心脏性猝死、非致命性心肌梗死发生率比较差异无统计学意义(P均>0.05).观察组反复缺血性心绞痛发生率明显低于对照组(P<0.05).2组并发症总发生率比较差异无统计学意义(P均>0.05),观察组再灌注心律失常发生率明显低于对照组(P<0.05).结论 术前使用替罗非班能有效降低PCI后血流灌注状态,并减少术后并发症的发生,值得临床广泛推广.%Objective It is to explore and analyze the effect of Tirofiban at different time on coronary flow and complica-tions in the patients with acute myocardial infarction after PCI.Methods 90 patients with acute myocardial infarction with up-ST segment undergoing PCI were randomly divided into observation group and control group.The control group was given Tirofiban during PCI, and the observation group was given Tirofiban before operation.TIMI blood flow, CTFC, 90 min ST seg-ment decrease percentage and occurrence rates of cardiac events and complications were observed and recorded in both groups. Results The improvements of CTFC, 90min ST segment decrease percentage in observation group were more significant than that in control group (P<0.05).There was no significant difference in TIMI blood flow degree before operation between the two groups (P>0.05), but after operation the differences in the numbers of TIMI blood flow 0-1, 2, 3 degree were signifi-cant (P<0.05).There was no significant difference in occurrence rate of sudden cardiac death, non-death acute myocardial infarction and total occurrence rate of complications between the two groups (P>0.05).The occurrence rate of repeated is-chemic angina pectoris and ischemia -reperfusion arrhythmia in observation group was obviously lower than that in control group (P<0.05).Conclusion Tirofiban used before treatment can effectively improve blood reperfusion after PCI, and re-duce post-operative complications, which is worthy of popularization and application.
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