CAJ | 학술논문

目的探讨急性ST段抬高型心肌梗死患者急诊介入治疗中应用替罗非班的有效性和安全性.方法接受急诊经皮冠状动脉介入疗法(PCI)治疗的急性ST段抬高型心肌梗死患者96例,按治疗方法分为治疗组和对照组,每组48例,治疗组在常规标准治疗的基础上采用替罗非班治疗,冠状动脉内注射替罗非班10 μg/kg,继之以0.15μg/(kg·min)静脉泵入24 ～ 48 h,对照组采用常规标准治疗.比较两组术后60 min心电图ST段回落率,冠状动脉血流TIMI分级,术后4周主要心脏不良事件(心绞痛、心肌梗死、心力衰竭、死亡)及出血发生情况.评价两种治疗方法的效果.结果治疗组术后60 min ST段完全回落45例(93.8％,45/48),对照组为35例(72.9％,35/48),两组比较差异有统计学意义(P＜0.05);梗死血管TIMI血流≥3级的发生率治疗组为95.8％(46/48),对照组为75.0％(36/48),两组比较差异有统计学意义(P＜0.05);术后4周主要心脏不良事件发生率低于对照组,差异有统计学意义(P＜0.05),两组出血发生率比较差异无统计学意义(P＞0.05).结论急性ST段抬高型心肌梗死患者急诊介入治疗术中应用替罗非班安全有效.
목적 탐토급성ST단태고형심기경사환자급진개입치료중응용체라비반적유효성화안전성.방법 접수급진경피관상동맥개입요법(PCI)치료적급성ST단태고형심기경사환자96례,안치료방법분위치료조화대조조,매조48례,치료조재상규표준치료적기출상채용체라비반치료,관상동맥내주사체라비반10 μg/kg,계지이0.15μg/(kg·min)정맥빙입24 ～ 48 h,대조조채용상규표준치료.비교량조술후60 min심전도ST단회락솔,관상동맥혈류TIMI분급,술후4주주요심장불량사건(심교통、심기경사、심력쇠갈、사망)급출혈발생정황.평개량충치료방법적효과.결과 치료조술후60 min ST단완전회락45례(93.8％,45/48),대조조위35례(72.9％,35/48),량조비교차이유통계학의의(P＜0.05);경사혈관TIMI혈류≥3급적발생솔치료조위95.8％(46/48),대조조위75.0％(36/48),량조비교차이유통계학의의(P＜0.05);술후4주주요심장불량사건발생솔저우대조조,차이유통계학의의(P＜0.05),량조출혈발생솔비교차이무통계학의의(P＞0.05).결론 급성ST단태고형심기경사환자급진개입치료술중응용체라비반안전유효.
Objective To investigate the efficacy and safety of tirofiban for emergency interventional therapy in patients with acute ST segment elevation myocardial infarction.Methods The 96 acute ST segment elevation myocardial infarction patients having accepted emergency percutaneous coronary intervention (PCI) were divided into treatment group and control group according to the treatment method with 48 cases each.The treatment group was given conventional standard treatment combined with tirofiban treatment [tirofiban intracoronary injection 10 μ g/kg and then intravenous 0.15 μ g/(kg· min) for 24-48 h].The control group was given conventional standard treatment only.The postoperative 60 min electrocardiogram ST segment recovery,the coronary blood flow TIMI grade,the major adverse cardiac events (angina,myocardial infarction,heart failure,death) and postoperative bleeding in 4 weeks were compared between the two groups.Results The patients having postoperative 60 min electrocardiogram ST segment recovery in treatment group was 45 cases (93.8％,45/48),in control group was 35 cases (72.9％,35/48),and there was statistical difference (P ＜ 0.05).The incidence rate of infarction vascular TIMI grade ≥ 3 grade flow in treatment group was 95.8％ (46/48),in control group was 75.0％ (36/48),and there was statistical difference (P ＜ 0.05).The incidence rate of the major adverse cardiac events 4 weeks in treatment group was significantly lower than that in control group,and there was statistical difference (P ＜ 0.05).There was no statistical difference in the incidence rate of bleeding between the two groups (P ＞ 0.05).Conclusion In patients with acute ST segment elevation myocardial infarction,the emergency interventional therapy with tirofiban is efficacy and safety.