目的:观察冠脉内注射替罗非班对急性ST段抬高型心肌梗死(STEMI)患者急诊经皮冠状动脉介入(PCI)治疗术中无复流的疗效.方法:将82例急性STEMI行急诊PCI术且术中出现无复流现象的患者分为2组,替罗非班组(48例)于冠脉内注入替罗非班10 μg· kg-1,5 min内注射完毕,继以0.15μg· kg-1·min-1静脉维持38 h；对照组(34例)于冠脉内注入维拉帕米200 μg,15 min内注射完毕.观察2组给药后20 min心肌梗死溶栓试验(TIMI)血流分级、TIMI心肌灌注分级(TMPG)和校正的TIMI帧数(CTFC).结果:给药后20 min,替罗非班组TIMI血流和TMPG心肌灌注3级获得率高于对照组,差异有统计学意义.给药前2组CTFC帧数差异无统计学意义,给药后20 min替罗非班组CTFC低于对照组,差异有统计学意义.结论:冠脉内注射替罗非班可以有效地改善STEMI急诊PCI术中无复流的现象.%Objective: To observe the influence of tiroflban treatment on no-flow phenomenon in patients with acute ST-elevation myocardial infarction (STEMI) during percutaneous coronary intervention (PCI). Method: Eighty-two STEMI patients with no-reflow phenomenon during PCI were randomly divided into tirofiban guoup (intracoronary tirofiban 10 ug ? Kg-1 and intravenous tirofiban 0.15 ug'kg-1 ?min-l for 36 hours, n=48) and control group (intracoronary verapamil 200ug, n=34). Thrombolyses in myocardial infarction (TIMI) flow grade, TIMI myocardial perfusion grade (TMPG) and corrected TI-MI frame count (CTFC) were compared between two groups 20 minute after giving the drug. Results: Compared with control group, the values of TIMI flow and TMPG3 were significantly higher in tirofiban group 20 minute after giving the drug. There was no significant difference in CTFC before treatment between two groups, but CTFC was significantly lower 20 minute after giving drug in tirofiban group than that of control group (P < 0.0S). Conclusion: Intracoronary injection of tirofiban can improve coronary arterial blood flow and myocardial tissue perfusion when no-flow occurred in PCI.
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