CAJ | 학술논문

目的：探讨冠状动脉内联合应用盐酸替罗非班与山莨菪碱对老年急性心肌梗死（ AMI）急诊经皮冠状动脉成形术（ PCI）治疗的可行性及临床疗效。方法将行PCI治疗的48例老年AMI患者随机分为2组，对照组22例单纯行PCI治疗，观察组26例在行PCI治疗的同时行冠状动脉内联合应用盐酸替罗非班与山莨菪碱。观察2组手术前后心肌梗死溶栓试验（ TIMI）血流分级、术后校正的TIMI血流计帧数（ CTFC）、TIMI心肌灌注分级（ TMPG），术前及术后1个月左心室舒张末容积（LVEDV）、左心室射血分数（LVEF），术后1个月内不良心血管事件（ MACE）发生率。结果术后2组冠脉血流均有改善，但观察组TIMI血流3级及TMPG 3级显著高于对照组（P均＜0．05），CTFC明显低于对照组（P＜0．05）；术后1个月观察组LVEDV及LVEF改善情况均明显好于对照组（P均＜0．05）；术后1个月观察组MACE发生率明显低于对照组（P＜0．05）。结论冠状动脉内联合应用盐酸替罗非班与山莨菪碱可明显增加老年AMI术后心肌组织灌注，改善心功能，降低MACE发生率。
목적：탐토관상동맥내연합응용염산체라비반여산랑탕감대노년급성심기경사（ AMI）급진경피관상동맥성형술（ PCI）치료적가행성급림상료효。방법장행PCI치료적48례노년AMI환자수궤분위2조，대조조22례단순행PCI치료，관찰조26례재행PCI치료적동시행관상동맥내연합응용염산체라비반여산랑탕감。관찰2조수술전후심기경사용전시험（ TIMI）혈류분급、술후교정적TIMI혈류계정수（ CTFC）、TIMI심기관주분급（ TMPG），술전급술후1개월좌심실서장말용적（LVEDV）、좌심실사혈분수（LVEF），술후1개월내불양심혈관사건（ MACE）발생솔。결과술후2조관맥혈류균유개선，단관찰조TIMI혈류3급급TMPG 3급현저고우대조조（P균＜0．05），CTFC명현저우대조조（P＜0．05）；술후1개월관찰조LVEDV급LVEF개선정황균명현호우대조조（P균＜0．05）；술후1개월관찰조MACE발생솔명현저우대조조（P＜0．05）。결론관상동맥내연합응용염산체라비반여산랑탕감가명현증가노년AMI술후심기조직관주，개선심공능，강저MACE발생솔。
Objective It is t explore the feasibility and clinical efficacy of combination with tirofiban and anisodamine on elderly patients with acute myocardial infarction ( AMI) who received percutaneous transluminal coronary angioplasty ( PCI) . Methods 48 cases of elderly patients with AMI undergoing PCI were randomly divided into 2 groups, the control group (22 ca-ses) were treated with PCI only, the observation group (26 cases) was given tirofiban hydrochloride combined with anisodam-ine at the same time of PCI therapy.Thrombolysis in Myocardial Infarction trial (TIMI) flow grade, postoperative corrected TIMI flow frame count ( CTFC) , TIMI myocardial perfusion grade ( TMPG) before and after PCI, left ventricular end diastolic volume ( LVEDv) and left ventricular ejection fraction ( LVEF) before operation and one month after PCI were observed, ma-jor adverse cardiovascular events ( MACE) one month after PCI.Results TIMI flow grade was improved after operation in both groups, but TIMI flow grade 3 and TMPG grade 3 in the observation group were significantly higher( P<0.05) while CTFC was significantly lower in observation group than that in control group (P<0.05);one month after operation the improvements of LVEDV and LVEF in observation group were significantly better than that in control group(P<0.05), in one month after PCI, the occurrence rate of MACE in observation group was obviously lower than that in control group (P<0.05).Conclu-sion Combined with tirofiban hydrochloride and anisodamine can significantly increase myocardial perfusion in elderly AMI af-ter PCI, improve heart function and reduce the incidence of adverse cardiovascular events.