关键词: 替奈普酶, 替罗非班, 急性心肌梗死, 经皮冠状动脉介入术

Abstract: Objective To analyze the therapeutic effect of the combination of tenecteplase and tirofiban in percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI). Methods A total of 120 AMI patients who underwent PCI in Shijiazhuang People's Hospital from June 2023 to January 2024 were collected and randomly separated into a tenecteplase group ( tenecteplase during surgery as control) and a test group ( tenecteplase in combined with tirofiban during surgery) with 60 patients in each. Two groups were compared for thrombolysis in myocardial infarction(TIMI) blood flow grading, TIMI myocardial perfusion grade(TMPG), myocardial injury markers[creatine kinase isoenzyme MB(CK-MB), cardiac troponin Ⅰ(cTnⅠ)], peak time, incidence of related bleeding events, echocardiography results [left ventricular end systolic diameter(LVESD), left ventricularend diastolic diameter(LVEDD), left ventricular ejection fraction(LVEF)] and incidence of major adverse cardiac events(MACEs). Results The proportion of immediate TIMI blood flow grade 3 and TMPG grade 3 in the test group was higher than that in control group(P＜0.05). The proportion of ST segment regression＞50% in test group(93.33% vs. 80.00%) was higher than that in the control group(P＜0.05). The peak time of CK-MB and cTnⅠ in test group was shorter than that in the control group(P＜0.05).Three months after surgery, the LVESD and LVEDD of the test group were lower than those before surgery and those of control group(P＜0.05), and the LVEF was higher than that before surgery and that of contemporaneous control group(P＜0.05). The incidence of MACEs at 3 months after surgery was lower in the test group(6.67% compared to 21.67%,P＜0.05). Conclusions The application of tenecteplase combined with tirofiban during PCI for AMI can effectively promote myocardial perfusion recovery and ST segment regression, significantly shorten the peak time of myocardial injury markers and improve heart function and reduce MACEs.

Key words: tenecteplase, tirofiban, acute myocardial infarction, percutaneous coronary intervention