静脉溶栓联合替罗非班治疗急性ST段抬高型心肌梗死的临床观察

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Abstract Objective To observe the efficacy and safety of intravenous thrombolysis with alteplase combined with domestic tirofiban in the treatment of ST-segment elevation acutemyocardial infarction（STEAMI）.M ethods 30 STEAMI patients admitted to our hospital from May 2012 to July 2013 were selected as the conventional group.These patients met theWHO diagnostic criteria，and could receive thrombolytic therapy≤3 hours and underwent coronary angiography（CAG）within 7 days.32 STEAMIpatients admitted to our hospital from September 2013 to November 2014 were selected as the combination group，and was given thrombolysis with alteplase and tirofiban therapy simultaneously.Patients from both groups were additionally given heparin injection via continuous intravenous infusion for 48 hours，ECG，myocardial enzymogram，activated partial thromboplastin time and CAG were recorded.The indicators of coronary recanalization and adverse drug reaction were observed，and the short-term efficacy and safety were evaluated.Results The peak value of CK-MB，peak time of CK-MB，the resolution of ST segment≥50%and in-hospitalmyocardial infarction for a second time between the combination group and the conventional group were not significant difference（P＞0.05）. Therewere significant differences in 5-7 days infarct-related artery（IRA）blood flow＞TIMIgradeⅢand the occurrence of unstable angina within seven days between the two groups（P＜0.05）.Prothrombin time prolongations at 24 h after thrombolysis between the two groups were significantly different（P＜0.05）.Platelet counts and bleeding events between the two groups were no significant difference（P＞0.05）.Conclusion Intravenous thrombolysis combined with domestic tirofiban hydrochloride in the treatment of STEAMI≤3 hours is superior to the conventional thrombolysis group in improving the infarct-related artery TIMI blood flow，the non-occurrence of unstable angina within 7 days，which is not increase the risk of bleeding.

Key words： Myocardial infarction Acute ST-segment elevation Alteplase Tirofiban

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CAIMei-lian. Clinical observation of intravenous thrombolysis combined w ith tirofiban in the treatment of ST-segment elevation acutem yocardial infarction[J]. 中国当代医药, 2016, 23(21): 29-32.

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http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2016/V23/I21/29

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