| Objective:With the continuous improvement of people’s living standards,the morbidity of coronary atherosclerotic heart disease(CAD)has been increased significantly,which has been the majority disease that threaten human health.The prevention and treatment of coronary heart disease are also under constant exploration and research.However,there is no clear method that can cure CAD [1].The aim of this trial was to combine thrombus aspiration with large doses of intravenous tirofiban in patients who have been diagnosed as acute ST-segment elevation myocardial infarction and accepted the emergency percutaneous coronary intervention therapy.We divide all the patients into two groups.One with the treatment of both Intravascular inject dosage of tirofiban and thrombus aspiration,the other were only accepted the intravascular injection therapy.We compare the effect and the prognosis of two groups,in order to find a better way to treat the patient with coronary heart disease.Methods:This study selected the patients from both emergency department and cardiology department of the First People’s Hospital of Plain County from November 2015 to June2017,who has been diagnosed as acute ST-elevation myocardial infarction.All the patients have accepted emergency PCI therapy according the 2012 Chinese guideline for percutaneous coronary intervention.70 patients were admitted,including 40 in the experimental group and 30 in the control group.All patients were treated with oral aspirin(100 mg/tablet)3 tablets,clopidogrel(75 mg/tablet)8 tablets,and rosuvastatin(20 mg/tablet)2 tablets before emergency PCI.Operation was done by the same experienced physician.Thrombus aspiration was performed in the experimental group,followed by intracoronary injection of tirofiban(25 μg/kg).Finally,PTCA and drug-eluting stent implantation were performed.The control group was treated with tiro.Intracoronary injection of Tirofiban and PTCA,drug-eluting stent implantation were performed.We also evaluated the indicators of the postoperatives.Results:The age,male proportion,and history of hypertension in the treatment group were(59.40±11.49)years old,9.00(22.50%),and 15(37.50%);the age of the control group,proportion of males,proportion of hypertension history were(59.06±11.40)years old,9.00(30.00%),10.00(33.00%);the age,male proportion,and history of hypertension in the two groups didn’t have significant different(P>0.05);Both of the two groups has no patient with TIMI O blood flow.There were 3.33%(1/30)of patients in the TIMI 1 blood flow in the control group and 0% in the experimental group(0/40)),the difference was significant(χ2=5.11,P<0.05);the blood flow of TIMI2 was 30.00%(9/30)in the control group and7.50%(3/40)in the experimental group.The difference was significant(χ2=5.66,P<0.05);the patients with TIMI3 blood flow were 66.67%(20/30)in the control group and 92.50%(37/40)in the experimental group.The difference was significant between the two groups(χ2=7.57,P<0.05);LVEF(49.56±9.23)% in the experimental group after PCI,and LVEF(43.13 ± 8.24)% in the control group after PCI(χ 2=2.11,P<0.05);After the emergency PCI,82.50%(33/40)of experimental patients has complete retraction of ST segment at 90 minutes and 56.66%(17/30)of control group,which has significant difference(χ2=5.61,P<0.05).During hospitalization,the control group had 3 cases of angina pectoris,2cases of myocardial reinfarction,4 cases of heart failure,1 case of cardiac death,and 33.33%(10/30)of total cardiac adverse events;while in the experimental group had 1 case of angina pectoris,1 case of myocardial reinfarction,2 cases of heart failure,0 cases of cardiac death,total incidence of adverse cardiac events 10.00%(4/40),which were significantly lower than the control group,the difference between the two groups was significant(P <0.05).Conclusions:The clinical efficacy of thrombus aspiration catheter combined with tirofiban in the treatment of STEMI patients is significant. |
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