盐酸替罗非班对STEMI患者急诊PCI术中无复流疗效观察.docVIP

盐酸替罗非班对STEMI患者急诊PCI术中无复流疗效观察 　　摘要：目的 探?盐酸替罗非班对急性ST段抬高型心肌梗死（STEMI）患者行急诊经皮冠状介入术（PCI）术中无复流的效果。方法 选取2015年5月-2016年5月在我院行急诊PCI且术中出现无复流现象的88例STEMI患者，将其分为观察组和对照组，各44例。对照组于冠脉内注入维拉帕米，观察组于冠脉内注入盐酸替罗非班，观察并比较两组给药后30min血流分级（TIMI）及校正的TIMI帧数（CTFC）。结果：对照组TIMI达3级24例（54.55%），低于观察组的36例（81.82%），两组比较差异有统计学意义（P0.05）。结论：盐酸替罗非班可有效改善STEMI患者行PCI术中无复流现象，更有利于改善预后 关键词：急性ST段抬高型心肌梗死；急诊PCI；无复流；盐酸替罗非班 Effect of Tirofiban Hydrochloride on No Reflow in Patients with STEMI Undergoing Emergency PCI WANG Li-jun，DONG Meng-shu，HE Wei-xi，WANG Ping （Department of Cardiology，Jingdezhen First People’s Hospital，Jingdezhen 333000，Jiangxi，China） Abstract：Objective To investigate the tirofiban on acute ST elevation myocardial infarction（STEMI）underwent emergency percutaneous coronary intervention（PCI）effect of no reflow during operation.Methods From May 2015-2016 year in May，88 cases of STEMI patients with no reflow phenomenon in our hospital emergency PCI and in operation，it was divided into observation group and control group，44 cases in each group.The injection of Vera Pammy in coronary artery，the observation group injected tirofiban on coronary artery were observed and compared between the two groups after administration of 30min flow grade（TIMI）and corrected TIMI frame count（CTFC）.Results The control group TIMI 3 cases 24（54.55%）， lower than the observation group in 36 cases（81.82%），there was significant difference between two groups （P0.05）.Conclusion Tirofiban hydrochloride can effectively improve the no reflow phenomenon in STEMI PCI patients，more conducive to improve the prognosis. Key words：Acute ST segment elevation myocardial infarction；Emergency PCI；No reflow；Tirofiban hydrochloride STEMI患者的急诊PCI能有效及时地开通梗死相关动脉并改善患者预后，但令人遗憾的是急诊PCI术中无复流（NR）现象使心肌组织得不到有效灌注，可明显恶化心功能及增加死亡率，NR的发生削弱了PCI的临床疗效，正确认识NR的发生机制及防治策略至关重要[1]。NR是指冠状动脉造影显示心外膜冠状动脉闭塞已减轻或消除后，缺血心肌的微循环血流仍不能完全恢复正常的一种现象，是微循环功能障碍的一种表现。无复流现象是急诊PCI的严重并发症，发生率高达25%～30%，是STEMI患者远期心血管事件的独立预测指标。本文通过对比研究，探讨盐酸替罗非班对急诊PCI术中无复流的治疗效果，现报告如下 1资料与方法 1.1一