| Background: Acute myocardial infarction (AMI) is one of the main death causes in coronary artery disease. AMI is based on the formation of acute thrombosis caused by the rupture of coronary atherosclerosis plaque,myocardial ischemic necrosis caused by acute luminal regional occlusion. Percutaneous Coronary Intervention (PCI) is the primary avenue of immediately liberating infarction-related artery (IRA), restoring myocardial availability reperfusion, reducing infarct size, saving ischemiacardiac muscle, improved left ventricular function and cutting down the mortality in AMI, improving long-term prognosis. In recent years, the Percutaneous Coronary Intervention (PCI) in AMI therapy is widely used, and has significant progress, but still reportedly10%～30%patients with PCI had happened no-reflow or slow-reflow phenome-nons,severely affect PCI therapeutic effect, less clinical observationshowed these patients benefit from PCI. Thromboplastic hypercoagulable state is related with platelet aggregation and plateket activationd. Aspirin and clopidogrel are routinely used in the therapies of AMI.But they only inhibite one pathway of platelet aggregation.while antagonist of glycoproteinⅡb/Ⅲa receptorof platelet m embrane can combined with the GPIIb/IIIa receptor of platelet membrane and the receptor of secondary fibronectin antagonises the activation of fibrinogen and vWF, and then blocks the final route of aggregation andactivation of plate-let.so as to achieve the greatest degree of antiplatelet effects.Adequately antipl-atelet therapy may improve myocardial microcirculation perfusion in patients after PCI, reduce the occurrence of no-reflow and slow-reflow phenomenonObjective: The clinical date and TIMI flow classification that in preoperation and postoperation which between application for Tirofiban group(A group) and the group without Tirofiban(B group)were analyzed retrospectively. Analysis of the effect of tirofiban used in the therapies of AMI.Methods:Subjects were the patients from cardiac Internal Medicine Department in Tianjin Chest Hospital since betwen January2011to March2013, who suffered from acute myocardial infarction and underwent PCI.Collected their information of clinical and coronary angiography. A group were those who used Tirofiban, with a total of296cases, male196and female100,(59.01±10.80) years old. B group were those underwent PCI within12-hour, not used Tirofiban, with a total of335cases, male220, female115,(61.12±10.85) years old. Records the clinical information (sex,age, smoking history, hypertension,diabetes, High blood cholesterol).and the preoperative and postoperative TIMI blood flow, the postoperative cardiac function in clinical manifestations (killip classification), determination of the left ventricular ejection,and the adverse reaction such as bleeding and thrombopeny and so on were observed, All date have been analysed statistically.Results:1.Comparision between the two groups of the general clinical date, There was no significant difference in age, sex, smoking history, hypertension, family his tory of diabetes, coronary heart diseasbetween the two groups (P>0.05).2.Sensitive troponin (CTnt), homocysteine (HCY), total cholesterol (TCHO), low density lipoprotein (LDL-C), high density lipoprotein (HDL-C) have no correlation with the occurrence of no reflow phenomenon.3.Comparision between the two groups, The TIMI blood classification before PCI and after PCI of the infarct-related artery has significant statistical differe nces (P<0.05).4.Comparision between the two groups, the Killip grades in the heart function and the left ventricular ejection fractions (LEVF) after PCI, have significant difference(P<0.05).5.Comparison between the two groups in hemoglobin, platelet count, and intern ational standard ratio (INR),have no significant difference (P>0.05). The inci-dence of bleeding complications had no significant difference (P>0.05). Conclusion:1. The TIMI blood classification of group A and B in which before PCI and after PCI of the infarct-related artery has significant statistical differences, and The TIMI blood classification in the group which used the Tirofiban before PCI and used the Tirofiban in the operation and after the operation has significant statistical differences,this shows that TIMI grades are increased after using Tirofiban,and the incidence of no/slow reflow phenomeno insignificantly reduced. In result early application can significantly improve the TIMI grade3flow rate and blood flow, improving coronary myocardial blood supply, increasing the blood perfusion, no-reflow and slow reflow occurred significantly less.The two groups after PCI classification of cardiac function and ejection fraction Killip showed significant difference, suggesting that tirofiban can improve the heart function.2.Additionally using Tirofiban has become a safety and valid measure to no/slow reflow after AMI with PCI.Additionally using Tirofiban does not increase incidence of serious adverse effects, such as bleeding. |
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