| Purpose:To explore the efficacy comparison of different doses of Tirofiban in emergency intervention patients with highly critical non-ST segment elevation MI.Methods: Random select 2019.09-2020.High-risk NSTEMI patients within 24 hours of the emergency Medicine Department of the Second Affiliated Hospital of Anhui Medical University : 1.After clinical diagnosis,ECG examination andmyocardial infarction markers,confirmed to be NSTEMI,consistent with the international clinical diagnosis standards;2.Patients were aware of the treatmentprotocol and voluntarily signed consent and implemented the study after approval of the Medical Ethics Committee of the hospital.A total of 60 cases were selected into 28 observers,16 males,12 females,34-83 years,mean age（63.33±13.34）,32 control group,20 males,12 females,37-83,mean age（63.03±12.77）.There was no significant difference between the generaldata of the two groups（P> 0.05）.Preoperative loading aspirin 300 mg + ticagrelor180 mg was administered in both groups.The experimental group performed PCIwith general heparin 100U/kg intrathecal artery injection and an initial measurement of 5 μg/kg,the distal end of the coronary artery by microcatheterwithin 3min,and then 0.075 μg· kg-1· min-1 for 36 h.The control group underwent emergency PCI,which received 100U/kg intrathecal artery infusion and an initialmeasurement of 10 μg/kg was injected into the distal end of the lesion with a microcatheter within 3min and then 0.15 μg ·kg-1 ·min-1 for 36 h.After surgery,allpatients regularly took aspirin 0.1g qd and ticagrelor 90 mg bid,atorvastatin 20 mg qn and low molecular molecule heparin calcium 4000 IU q12h 5-7d.Posttroponin Iand cardiac ultrasound fraction were compared between the two groups.Postoperative bleeding evaluation: gingival bleeding;gastrointestinalbleeding;intracranial hemorrhage.Comparison of the incidence of adverse cardiac events（persistent arrhythmias,heart failure,cardiac arrest,or death）in patientsone month after surgery.Data were processed in SPSS23.0 software package,measurement data in x ±s,t-test;count data in examples（%）,2 test,P <0.05 isstatistically significant.Result:There was no significant difference between the postoperative troponin Iand LVEF statistics between the observed and control groups（P> 0.05）,and the low-dose Tirofiban could achieve the same treatment effect.In the control group,three gingival bleeding（9.375%）and one cerebral hemorrhage（3.125%）were higher than those observed in the observation group,and there were statisticaldifferences between the groups（P <0.05）.No adverse cardiac events were observed in the control and observed groups within 1 month after surgery.Conclusion:1.The comparison between the two high-risk acute non-ST elevation patients（c Tn I,LEVF after emergency PCI）（P> 0.05）showed that the effect of small-dose Tirofibanwas similar to that of normal dose,and also had a positive therapeutic effect in emergency PCI surgery.2.The incidence of treatment process bleeding events reflects the adverse effects of the treatment regimen,and the analysis results show: The results concluded thatThe total incidence of postoperative bleeding in the control group of 12%（3gingival bleeding,1 cerebral hemorrhage,4 / 32）was higher than the observationgroup of 0%（0 / 28）.There were statistical differences between the two groups（P<0.05）,indicating that small-dose PCI for acute non-ST elevation patients couldreduce the risk of bleeding while achieving similar efficacy.Neither group had a significant blood check decrease in hemoglobin or platelet count.3.For patients with high critical non-ST elevation MI requiring emergency PCI treatment,low-dose dose is safer with the same or similar efficacy,reducingbleeding risk and effective for short-term treatment of acute non-ST elevation MI.4.This trial is mainly focused on a single center with a low sample size.For thelong-term treatment effect,clinical studies of the extended follow-up period and large samples are still pending. |
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