冠脉内推注替罗非班对STEMI患者行急诊PCI术血管血流与临床预后的影响.pdf

　 安　 徽　 医　 学 第35卷第11期 1490 Anhui Medical Journal　 　 　 　 　 　 　 　 　 　 　 　 　 　 　 　 　 2014年11月 冠脉内推注替罗非班对STEMI患者行急诊PCI术血管血流与临床预后的影响 江荣炎　 蒋爱清　 吴　 桥　 卜令同　 陈多学　 王　 敏 　 　 [摘要]　 目的　 评价急性ST段抬高性心肌梗死STEMI患者行急诊经皮冠状动脉介入(PCI)术时经血栓抽吸后冠脉应用替罗非 班对梗死相关血管血流及临床预后的影响。 方法　 将114例患者随机分为替罗非班组与对照组,比较两组TIMI血流、TMPG分级、心 功能的改变、出血事件以及住院期间MACE事件率。 结果　 替罗非班组术后TIMI血流及TMPG分级均优于对照组,LVEF 明显高于对 照组(P0.05),住院期间MACE低于对照组(P0.05),两组出血事件及LVEDD差异无统计学意义(P0.05)。 结论　 血栓抽吸后 冠脉内应用替罗非班是处理冠状动脉内血栓安全、有效的方法,可减少慢血流或无血流的发生,改善心肌灌注及近期预后。 [关键词]　 替罗非班;急性心肌梗死;冠状动脉介入治疗 doi:10.3969/ j.issn.1000-0399.2014.11.005 Effects of intracoronary tirofiban on blood flow and clinical outcomes of STEMI patients during primary PCI Jiang Rongyan,JiangAiqing,Wu Qiao,et al Department of Cardiology,People’s Hospital of Buozhou,Buozhou236800,China [Abstract]　 Objective　 Toevaluatetheeffectsof intracoronarytirofibanonbloodflow andclinical outcomesof STEMIpatientsafter thrombus aspiration duringprimary PCI. Methods Atotal of 114 caseswererandomly divided intothetirofiban group andthe control group. The TIMI flow,TMPG classification,changes in heart function,bleeding events and MACE events rate during hospitalization were compared between the two groups. Results The TIMI flow and TMPG grading of the tirofiban group were superior to those of the control group,LVEF was also significantly higher than that of the control group (P 0.05),MACE during hospital was lower than that of the control group (P 0.05),and bleedingeventsandLVEDDweresimilarbetweenthetwogroups (P 0.05). ConclusionUseofintracoronarytirofibanaf- ter thrombus aspiration is safe and effective in preventing the slow-flow or no-flow phenomenon,and it can improve myocardial perfusion and recent prognosis. [Key words]Tirofiban;Acute myocardial infarction;Coronary intervention 　 　 急性ST段抬高性心肌梗死(ST-segmentelevation 性72例,女性42例;平均年龄(