标题：替罗非班在急性心肌梗死行急诊PCI治疗中的应用价值

      作者：吴蓝津，吴万芬，陆山河    (广西民族医院心血管三区，广西 南宁 530001)

      卷次： 2017年28卷10期

      【摘要】 目的 探讨替罗非班在急性心肌梗死行急诊经皮冠状动脉介入 (PCI)治疗中的临床应用价值。方法 选择我院心内科于 2015年 4月至 2016年 10月期间收治的 92例急性 ST段抬高型心肌梗死(STEMI)患者为研究对象，根据随机数表法随机分为观察组(n=48)与对照组(n=44)，所有患者均接受急诊PCI治疗，其中观察组术前应用替罗非班，对照组则不予应用。比较两组患者PCI术后心肌梗死溶栓试验(TIMI)血流分级情况以及TIMI心肌灌注(TMPG)分级的变化，同时比较出血发生率及心血管不良事件发生率。结果 观察组患者PCI术后TIMI血流分级2~3级比例为95.83%，与对照组的93.18%比较差异无统计学意义(P>0.05)；而观察组患者TMPG2~3级的比例为89.58%，明显高于对照组的72.73%，差异有统计学意义(P<0.05)；两组患者出血发生率比较差异无统计学意义(P>0.05)；观察组患者术后心血管不良事件发生率为4.17%，明显低于对照组的18.18%，差异有统计学意义(P<0.05)。结论 急诊 PCI术前应用替罗非班可有效改善STEMI患者冠状动脉血流及心肌灌注，从而减少心血管不良事件发生率，改善近期预后。
      【关键词】 急性心肌梗死；经皮冠状动脉介入；替罗非班；心肌梗死溶栓试验；心肌灌注
      【中图分类号】 R542.2+2 【文献标识码】 A 【文章编号】 1003—6350（2017）10—1572—03

Clinical value of tirofiban in patients with acute myocardial infarction treated by emergency percutaneouscoronary intervention.
WU Lan-jin, WU Wan-fen, LU Shan-he. Cardiovascular Department Ⅲ, Guangxi NationalHospital, Nanning 530001, Guangxi, CHINA
【Abstract】 Objective To investigate the clinical value of tirofiban in the treatment of acute myocardial infarc-tion with percutaneous coronary intervention (PCI). Methods From April 2015 to October 2016, 92 patients of acuteST elevation myocardial infarction (STEMI) were recruited and, according to random number table, divided into obser-vation group (n=48) and control group (n=44). All patients received emergency PCI treatment, and the observation groupapplied tirofiban before operation. Comparison was performed on thrombolysis in myocardial infarction (TIMI) flowgrade classification after PCI and changes of TIMI myocardial perfusion (TMPG) classification, as well as the incidenceof bleeding and adverse cardiovascular events. Results The proportion of TIMI flow grade classification 2-3 after PCIwas 95.83% in the observation group and 93.18% in the control group, showing no statistically significant difference be-tween the two groups (P>0.05). The proportion of TMPG 2-3 was 89.58% in the observation group, which was signifi-·论 著·doi:10.3969/j.issn.1003-6350.2017.10.008