CAJ | 학술논문

目的：研究替罗非班静脉内注射、冠状动脉内注射两种不同给药途径在急性 ST 段抬高型心肌梗死急诊 PCI 中的应用价值。方法选取行急诊 PCI 的急性 ST 段抬高型心肌梗死患者108例为研究对象，将患者按随机数字表法分为观察组和对照组，各54例，观察组 PCI 治疗时通过冠脉内注射首剂量替罗非班，对照组通过静脉内注射，比较两组治疗后的血管造影结果、心电图、实验室相关指标及不良事件发生情况。结果观察组治疗前 TIMI 2级及3级比率、初始校正 TIMI 计帧数明显低于对照组，差异有统计学意义（χ2／t ＝4．32、4．59、5．25，均 P ＜0．05），观察组在治疗后 MBG 2级或3级比率、术后校正 TIMI 计帧数明显高于对照组，差异有统计学意义（χ2／t ＝4．11、4．85、5．87，均 P ＜0．05）。观察组 PCI 治疗术后1 h ST 完全回落例数、EF增加值、室璧运动分数指数增加值分别为53例、（8．02±6．94）％、（0．41±0．28），均明显高于对照组的36例、（5．87±6．54）％、（0．28±0．27）（χ2／t ＝5．32、4．32、3．65，均 P ＜0．05）。两组不良事件发生情况差异无统计学意义（χ2＝0．52，P ＞0．05）。结论与静脉内注射的给药途径相比，替罗非班冠状动脉内给药可改善急性ST 段抬高型心肌梗死患者 PCI 治疗术后心肌灌注水平，促进左室功能恢复，且安全性高。
목적：연구체라비반정맥내주사、관상동맥내주사량충불동급약도경재급성 ST 단태고형심기경사급진 PCI 중적응용개치。방법선취행급진 PCI 적급성 ST 단태고형심기경사환자108례위연구대상，장환자안수궤수자표법분위관찰조화대조조，각54례，관찰조 PCI 치료시통과관맥내주사수제량체라비반，대조조통과정맥내주사，비교량조치료후적혈관조영결과、심전도、실험실상관지표급불량사건발생정황。결과관찰조치료전 TIMI 2급급3급비솔、초시교정 TIMI 계정수명현저우대조조，차이유통계학의의（χ2／t ＝4．32、4．59、5．25，균 P ＜0．05），관찰조재치료후 MBG 2급혹3급비솔、술후교정 TIMI 계정수명현고우대조조，차이유통계학의의（χ2／t ＝4．11、4．85、5．87，균 P ＜0．05）。관찰조 PCI 치료술후1 h ST 완전회락례수、EF증가치、실벽운동분수지수증가치분별위53례、（8．02±6．94）％、（0．41±0．28），균명현고우대조조적36례、（5．87±6．54）％、（0．28±0．27）（χ2／t ＝5．32、4．32、3．65，균 P ＜0．05）。량조불량사건발생정황차이무통계학의의（χ2＝0．52，P ＞0．05）。결론여정맥내주사적급약도경상비，체라비반관상동맥내급약가개선급성ST 단태고형심기경사환자 PCI 치료술후심기관주수평，촉진좌실공능회복，차안전성고。
Objective To study tirofiban intravenous injection,coronary artery injection of the two different methods in acute ST segment elevation myocardial infarction,the application of emergency PCI.Methods Patients underwent emergency PCI with acute ST segment elevation myocardial infarction as the research subjects,a total of 108 cases,the patients were randomly divided into the observation group and control group,54 patients in each group. In the observation group,the first dose of tirofiban was injected into the coronary artery.The control group was treated by intravenous injection.The results of the two groups were compared.Results Before treatment,TIMI level 2 and level 3 ratio,initial corrected TIMI frame count of the observation group were significantly lower than the control group (χ2 /t =4.32,4.59,5.25,all P <0.05).After treatment,MBG level 2 or level 3 ratio,post -operative corrected TIMI frame count of the observation group were significantly higher than the control group (χ2 /t =4.11,4.85,5.87, all P <0.05).1 h after PCI treatment,the number of cases of ST fully back,the added value of EF,plague index scores of observation group were 53 cases,(8.02 ±6.94)%,(0.41 ±0.28)respectively,which were significantly higher than those of the control group 36 cases,(5.87 ±6.54)%,(0.28 ±0.27)(χ2 /t =5.32,4.32,3.65,all P <0.05).Adverse events of the two groups had no significant difference (χ2 =0.52,P >0.05).Conclusion Compared with intravenous injection,tirofiban in the treatment of acute ST segment elevation myocardial infarction by intracoronary injection can improve the level of myocardial perfusion after PCI operation,promote the recovery of left ventricular function,and has high security.