CAJ | 학술논문

目的：探讨替罗非班治疗心肌梗死患者经皮冠状动脉介入治疗（PCI）后血运重建不良方面的临床疗效，为该类疾病的临床治疗提供参考。方法以第三军医大学大坪医院2009年2月至2013年1月收治的200例PCI术中出现“无复流”或“慢血流”的心肌梗死患者为研究对象，将其随机分为对照组和治疗组。对照组PCI术中加用硝酸甘油，治疗组加用硝酸甘油和替罗非班。观察两组患者的临床治疗效果。结果治疗后，对照组与治疗组患者的TIMI血流分级和TMP心肌灌注分级均有明显改善，且差异有统计学意义（P＜0．05）。治疗组TIMI血流分级与TMP心肌灌注分级明显高于对照组，差异有统计学意义（P＜0．05）。治疗后，两组患者的校正TIMI帧数均优于治疗前，且治疗组优于对照组，差异有统计学意义（P＜0．05）。1周后，治疗组患者的左心室舒张末期直径和左心室射血分数均优于对照组，且组间差异有统计学意义（P＜0．05）。结论PCI术中加用替罗非班能够有效改善急性心肌梗死患者的血运重建不良症状，其临床疗效比单独使用硝酸甘油时更为理想。
목적：탐토체라비반치료심기경사환자경피관상동맥개입치료（PCI）후혈운중건불량방면적림상료효，위해류질병적림상치료제공삼고。방법이제삼군의대학대평의원2009년2월지2013년1월수치적200례PCI술중출현“무복류”혹“만혈류”적심기경사환자위연구대상，장기수궤분위대조조화치료조。대조조PCI술중가용초산감유，치료조가용초산감유화체라비반。관찰량조환자적림상치료효과。결과치료후，대조조여치료조환자적TIMI혈류분급화TMP심기관주분급균유명현개선，차차이유통계학의의（P＜0．05）。치료조TIMI혈류분급여TMP심기관주분급명현고우대조조，차이유통계학의의（P＜0．05）。치료후，량조환자적교정TIMI정수균우우치료전，차치료조우우대조조，차이유통계학의의（P＜0．05）。1주후，치료조환자적좌심실서장말기직경화좌심실사혈분수균우우대조조，차조간차이유통계학의의（P＜0．05）。결론PCI술중가용체라비반능구유효개선급성심기경사환자적혈운중건불량증상，기림상료효비단독사용초산감유시경위이상。
Objective To investigate the clinical effect of tirofiban for the treatment of acute myocardial infarc‐tion(AMI) patients with poor blood supply after percutanecus coronary intervention(PCI) .Methods A total of 200 AMI patients with blood flowing slowly and no‐reflow were selected as the objects in Daping Hospital Affiliated to the Third Military Medical University from February 2009 to January 2013 .All the patients were divided into treat‐ment group and control group randomly .The control group was treated with nitroglycerin after PIC ,the treatment group was treated with nitroglycerin and tirofiban after PIC .Compared the clinical effect of the two groups after re‐ceived treatment .Results After treatment ,the thrombolysis in myocardial infarction (TIMI) flow grade and the my‐ocardial perfusion ( TMP) grade of the two groups were all better than those pre-treatment ,and the differences be‐tween pre-treatment and post -treatment were statistically significant (P<0 .05) .The TIMI flow grade and the TMP grade of treatment group were higher than those of the control group ,and the difference was statistically signif‐icant (P<0 .05) .The post-treatment corrected TIMI frame count (CTFC) of the two groups was better than that pre-treatment (P< 0 .05) ,and the treatment group was better than control group (P< 0 .05) .After treating 1 week ,the left ventricular end-diastolic dimension ( LVEDD) and left ventricular ejection fraction (LVEF) of treat‐ment group was better than those of the control group ,and the differences were statistically significant (P<0 .05) . Conclusion Using tirofiban during the operation of PCI could effectively improve the adverse revascularization ,the clinical effect was better than nitroglycerin using alone .