替罗非班对ST段抬高AMI患者PCI后心肌灌注及心肌损伤的影响_医学论文.docVIP

替罗非班对ST段抬高AMI患者PCI后心肌灌注及心肌损伤的影响_医学论文 替罗非班对ST段抬高AMI患者PCI后心肌灌注及心肌损伤的影响_医学论文 【摘要】 观察使用替罗非班对ST段抬高心肌梗死患者(AMI)冠状动脉介入术（PCI）后心肌灌注及心肌损伤的影响。方法：首次因急性ST段抬高AMI行急诊PCI治疗的76例患者，随机分为对照组38例，试验组（替罗非班）38例。试验组于PCI术前开始给予盐酸替罗非班，观察对照组和试验组PCI术后15min校正的TIMI帧数计数（CTFC）和进行冠状动脉血流速度测定，并比较发病就诊时，PCI术后6h，12h 的cTnT，CK水平；记录住院期间主要心血管事件（MACE）发生率。结果：试验组CTFC和冠状动脉血流速度同对照组比较明显改善（0.05），两组患者术前cTnT和CK水平相比无统计学差异，在术后6h及12h试验组cTnT和CK水平均较对照组明显降低（0.05）。试验组患者中发生1例顽固性心肌缺血；而对照组新发心肌梗死和顽固性心肌缺血各有1例。结论： 在ST段抬高AMI行PCI治疗时应用替罗非班，可明显改善心肌再灌注，减少心肌损伤的发生，同时改善PCI术后患者MACE发生率。 【关键词】 替罗非班 心肌梗死 冠状动脉介入术 Effect of Tirofiban on Reperfusion and Myocardial Injury after Percutaneous Coronary Intervention in Patients with ST Elevation Myocardial Infarction AbstractObjective:To observe the effect of tirofiban on reperfusion and myocardial injury after percutaneous coronary intervention(PCI) in patients with ST elevation myocardial infarction(STEMI).Methods: Seventysix patients with STEMI, who were treated with PCI were designed into two groups randomly: control group (38 cases) and tirofiban group (38 cases). Corrected TIMI frame count(CTFC) and blood flow velocity were observed. Creatine kinase isoenzyme MB (CKMB ) and cardial troponin T(cTnT ) were assayed at base line and 6h as well as 12h after PCI in two groups. The rate of major adverse cardiac events (MACE) was observed.Results: CTFC and blood flow velocity in tirofiban group were significantly better than those in control group（0.05）.And there was no significant difference between the two groups at the level of CKthe level of CKMB and cTnT in tirofiban group was lower than that in control group at 6h,12h after PCI(P lt0.05). MACE was lower in tirofiban group than that in control group.Conclusion: In patients with STEMI, tirofiban may improve CTFC and blood flow velocity, reduce myocardial injury and lower the rate of MACE after PCI. Ｋｅｙ　ｗｏｒｄｓtirofiban myocardial infarction percutaneous coronary intervention 尽早开通梗死相关血管(IRA)是治疗急性心肌梗死(AMI)的关键，理想的冠状动脉介入治疗 (percutaneous coronary in