替罗非班在急性心肌梗死经皮冠状动脉介入治疗中的应用

摘要] 目的：初步探讨急性心肌梗死患者接受择期PCI时应用替罗非班对冠脉血流和组织灌注及术后心血管事件的影响。资料与方法：收集武汉市一医院心内科2004年7月～2007年7月收住的急性心肌梗死（AMI）行经皮冠状动脉介入治疗(PCI)108例患者的临床资料。其中，63例行常规PCI治疗（PCI组），45例患者行常规PCI+替罗非班治疗（替罗非班组），分析比较两组患者的术后一周左心室射血分数、出血并发症、PCI术后即刻结果分析和30天内心血管事件。结果：与PCI组相比, 替罗非班组PCI术后TIMI3级血流获得率较PCI组高，但差异无统计学意义（P＞0.05）；TMPG灌注分级3级获得率、术后一周左室射血分数高于PCI组（P＜0.05）差异有统计学意义，TIMI帧计数示血流快于PCI组（P＜0.05），30天内的主要心血管事件发生率低于PCI组（P＜0.05）差异有统计学意义；出血并发症有高于PCI组趋势，但差异无统计学意义（P＞0.05）。结论：急性心肌梗死患者接受择期PCI时应用替罗非班具有更好的血流和组织灌注，进一步改善围术期心功能，并明显减少AMI患者30天心血管事件的发生率。

Tirofiban Applied in Patients With Acute Myocardial Infarction Treated by Percutaneous Coronary Intervention

Tirofiban Applied in Patients With Acute Myocardial Infarction Treated by Percutaneous Coronary Intervention TIAN Li-qun, BA Ying-ba te, ZHENG Qiong-li, LEI Jian, LI Zuo-min, KE Yu-he Department of Cardiology, Wuhan first public hospital,Wuhan,430022,china Abstract] Objective:To observe the effect of tirofiban in percutaneous coronary intervention of patients with acute myocardial infarction. Method: 108 patients with acute myocardial infarction underwent PCI from July 2004 to July 2007. These patients were divided into two groups: PCI group (n=63) and PCI+Tirofiban group (n=45). Baseline characteristics of the two groups were compared. TIMI grade, Corrected TIMI frame count(CTFC) and TIMI myocardial perfusion grade (TMPG) were studied immediately after PCI. And assessed the MACE in 30 days.Results: Although TIMI flow after PCI were similar in two groups, Compared with PCI group , TMPG 3 grade rate post PCI was high and CTFC was low in Tirofiban group( P<0.05). MACE in 30 days was higher in PCI group than in Tirofiban group( P<0.05).Conclusion: Tirofiban can improves microvascular perfusion in percutaneous coronary intervention of patients with acute myocardial infarction.