CAJ | 학술논문

目的：探讨在冠状动脉介入术(PCI)前开始静脉使用盐酸替罗非班治疗老年急性 ST 段抬高型心肌梗死(STEMI)患者的疗效和安全性。方法入选78例老年 STEMI 患者，分为试验组(n=40)和对照组(n=38)。对照组按急性心梗给予阿司匹林、氯吡格雷等常规药物治疗，试验组在对照组基础上加用盐酸替罗非班治疗，观察替罗非班对患者手术前后TIMI血流分级、术后30 d和60 d不良心脏事件(MACE)、出血情况。结果术后两组 TTIMI3级血流分级、术后30 d和60 dMACE发生率(主要是心绞痛和再发心肌梗死率)，差异均有统计学意义(P<0.05)；而试验组和对照组出血并发症无差别。(P>0.05)。结论替罗非班能改善PCI手术前后的 TIMI 血流，有利于改善急性心梗缺血心肌的供血，同时未增加出血的风险。
목적：탐토재관상동맥개입술(PCI)전개시정맥사용염산체라비반치료노년급성 ST 단태고형심기경사(STEMI)환자적료효화안전성。방법입선78례노년 STEMI 환자，분위시험조(n=40)화대조조(n=38)。대조조안급성심경급여아사필림、록필격뢰등상규약물치료，시험조재대조조기출상가용염산체라비반치료，관찰체라비반대환자수술전후TIMI혈류분급、술후30 d화60 d불양심장사건(MACE)、출혈정황。결과술후량조 TTIMI3급혈류분급、술후30 d화60 dMACE발생솔(주요시심교통화재발심기경사솔)，차이균유통계학의의(P<0.05)；이시험조화대조조출혈병발증무차별。(P>0.05)。결론체라비반능개선PCI수술전후적 TIMI 혈류，유리우개선급성심경결혈심기적공혈，동시미증가출혈적풍험。
Objective To discuss the curative effect of tirofiban on myocardial reperfusion used before percutaneous coronary intervention(PCI) in the old patients with acute ST-elevation myocardial infarction (STEMI).Methods A total of 78 old patients acute STEMI were enrolled in the trial from Jan.2011 to Dec.2013;they were randomly divided into 2 groups:tirofiban group(n=40) and placebo group(n=38).The control group was given aspirin and clopidogrel and other drugs,and the tirofiban group,tirofiban besides routine treatment. The influences of tirofiban on coronary blood flow,30 days mace and 60 days mace (especially angina pectoris and myocardial infarction cardiac infarction) and bleeding were observed.Results The occurrence of TIMI grade 1 flow before PCI,and occurrence of TIMI grade 3 and 2 after PCI in the tirofivan group were superior to those in the control group (P<0.05).The comparisons in 30 days mace and 60 days mace (especially angina pectoris and myocardial infarction cardiac infarction) after PCI between two groups showed statistical differences (P<0.05).The percentage of mild bleeding was 10.0% in the tirofiban group and 10.53% in the control group and the difference was not statistically significant(P>0.05).Conclusion Tirofiban can improve TIMI flow before and after PCI and is helpful to reperfusion of ischemia myocardial,but don’t increases the risk of mild bleeding.