CAJ | 학술논문

目的：探讨依诺肝素联合替罗非班治疗急性心肌梗死的疗效和安全性。方法选取我院2011年11月至2013年1月收治的急性心肌梗死患者120例，将其随机分为治疗组和对照组各60例。两组患者均给予静脉溶栓、培哚普利/或氯沙坦、硝酸甘油、美托洛尔、氯吡格雷、阿托伐他汀钙、拜阿司匹林、依诺肝素等常规治疗。治疗组溶栓后于静脉泵入替罗非班，首先为0.4μg·kg-1·min-1，30min，然后为0.15μg·kg-1·min-1。观察两组患者的出血情况、梗死血管再通、心脏不良事件(MACE)等。结果治疗组的血管间接再通情况与直接再通情况均优于对照组，两组的有效率比较，具有显著差异，P<0.05；治疗组的出血人数比对照组多，两组比较差异具有统计学意义(P<0.05)。结论替罗非班用于治疗AM陨同尿激酶静脉溶栓联合应用，安全有效，适合推广应用。
목적：탐토의낙간소연합체라비반치료급성심기경사적료효화안전성。방법선취아원2011년11월지2013년1월수치적급성심기경사환자120례，장기수궤분위치료조화대조조각60례。량조환자균급여정맥용전、배타보리/혹록사탄、초산감유、미탁락이、록필격뢰、아탁벌타정개、배아사필림、의낙간소등상규치료。치료조용전후우정맥빙입체라비반，수선위0.4μg·kg-1·min-1，30min，연후위0.15μg·kg-1·min-1。관찰량조환자적출혈정황、경사혈관재통、심장불량사건(MACE)등。결과치료조적혈관간접재통정황여직접재통정황균우우대조조，량조적유효솔비교，구유현저차이，P<0.05；치료조적출혈인수비대조조다，량조비교차이구유통계학의의(P<0.05)。결론체라비반용우치료AM운동뇨격매정맥용전연합응용，안전유효，괄합추엄응용。
Objective To investigate the efficacy and safety of the combined treatment of enoxaparin tirofiban for acute myocardial infarction. Methods 120 patients with acute myocardial infarction in our hospital from November 2011 to January 2013 were randomly divided into treatment group and control group, with 60 cases in each group. These patients were given intravenous thrombolysis, perindopril or losartan, nitroglycerin, metoprolol, clopidogrel, atorvastatin calcium, aspirin, enoxaparin and other conventional treatment. The treatment group were given intravenous infusion of tirofiban after thrombolysis, firstly 0.4 μg·kg-1·min-1, 30 min, and then 0.15 μg·kg-1·min-1. Bleeding, infarction recanalization and adverse cardiac events (MACE) were observed. Results The indirect recanalization and direct recanalization in the treatment group were better than those in the control group. There was significant difference between the effective rates between the two groups (P <0.05). The number of patients with bleeding in the treatment group was significantly larger than that in the control group (P <0.05). Conclusions Tirofiban combined with intravenous thrombolysis with urokinase for the treatment of acute myocardial infarction is safe, effective, which is worthy of clinical application.