Effects Of Tirofiban Combined With Sodium Nitroprusside In Patients With T—segment Elevation Mvocardial Infarction With No Reflow In PCI

ObjectiveTo study the effects of microcatheter intracoronary injection timfiban combined with sodium nitroprusside in patients with T-segment elevation mvocardial infarction with no reflow in PCI.To study the effect of intracoronary administration of sodium nitroprusside and tirofiban via microcatheter,and intracoronary administration of nitroglycerin and tirofiban on intraoperative and postoperative TIMI blood flow in patients with acute ST-segment elevation myocardial infarction(STI)without reflow during emergency PCI,as well as on the incidence of short-term postoperative adverse cardiovascular events.MethodAsk for details of patient’s medical history and the main symptoms,medication history and history of allergies,etc.,physical examination,perfect the blood routine blood biochemical,myocardial infarction markers,blood coagulation indicators,BNP natriuretic peptides,the electrocardiogram(ecg)and related inspection,to identify patients with STEMI,first to give medicine(aspirin 0.3 g,clopidogrel 300 mg)chewing,according to patients condition choose radial artery or femoral artery puncture for surgical approach,and then by the piercing artery sheath tube into the heparin 3000 u,as after coronary interventional treatment prolonged,with 1000 u/h to push on,lntra-arterial heparin injection was performed again at 60U/kg at the start of the interventional operation.Patients with no reflux during emergency PCI were divided into two groups according to the random number table method,with 20 cases in each group.The control group was treated as follows:tirofiban was first injected into the coronary artery through microcatheter,and then nitroglycerin was given in the same way with the dose of 200ug;The observation group was first given the same dose of tirofiban in the same way,followed by intravenous injection of niroprane in the same way with a dose of 300ug.The dose of tirofiban in the two groups was calculated as 10ug/kg,and the injection should be completed within 2 minutes.Three minutes later,coronary angiography was performed to observe and determine TIMI blood flow.Grade 3 indicated effective and grade 0-2 indicated ineffective.Patients in both groups were continuously injected intravenously with tirofiban for 24h after surgery,at a rate of 0.15ug/kg/min,and under the condition that there was no obvious bleeding tendency after surgery,they were given dual antiplatelet aggregation,anti-lipid-regulating plaque stabilization,delaying myocardial remodeling and other drugs.Results1.The results of preoperative basic information and preoperative coronary angiography of patients in the two groups were statistically processed,and the P value was greater than 0.05,showing no statistical difference.2.After treatment in the experimental group or control group,coronary angiography was performed again,and TIMI blood flow was observed and recorded.The results showed a statistically significant difference with P value less than 0.05 after statistical treatment.3.The incidence of intraoperative and postoperative adverse complications in the two groups was statistically processed,and the P value was less than 0.05,indicating a statistically significant difference.Conclusion1.Tirofiban combined with sodium nitroprusside can improve postoperative TIMI blood flow in patients with acute STEMI PCI without reflow;2.Tirofiban combined with sodium nitroprusside can reduce the incidence of intraoperative and postoperative short-term complications in patients with STEMI who have no reflow during emergency PCI.