冠状动脉内注射替罗非班对急性心肌梗死患者.docVIP

冠状动脉内注射替罗非班对急性心肌梗死患者介入治疗中无复流现象的疗效研究liwx1818@163.com 通讯地址：天津医科大学宝坻临床学院心内科 张红雨 邮编：301800 摘要：目的观察冠状动脉内注射替罗非班急性心肌梗死（AMI）患者经皮冠状动脉介入治疗（PCI）术中无复流现象的疗效。 方法替罗非班组为2005年1月至2009年9月AMI患者行PCI术中出现无复流现象后给予冠状动脉内注入替罗非班的患者46例；对照组为同期AMI患者行PCI术中出现无复流现象后给予冠状动脉内注入维拉帕米患者49例。观察两组患者注射药物后首次和PCI手术结束前末次冠状动脉造影图像，评估心肌梗死溶栓试验（TIMI）血流分级、矫正的TIMI帧数（cTFC）、TIMI心肌组织灌注分级（TMPG）结果冠状动脉内注射药物后首次及PCI结束前末次冠状动脉造影均显示替罗非班组TIMI3级血流比例明显高，分别为63.0% 比40.8% , P＜0.05）78.3% 比49.0% P＜0.01）替罗非班组cTFC帧数明显，分别为38.6±7.1比49.3±9.3P＜0.01）28.5±6.4比40.4±8.7P＜0.01）替罗非班组TMPG 3级血流比例明显高，分别为54.3% 比32.7% P＜0.05）71.7% 比46.9% ，P＜0.05）。结论冠状动脉内注射替罗非班可以AMI患者PCI术中发生无复流现象后冠状动脉血流和心肌组织灌注为AMI患者PCI术中出现无复流现象后的一种简单有效的治疗方法。 关键词冠状动脉血管成形术经腔经皮冠状动脉无复流现象替罗非班急性心肌梗死Clinical study of intracoronary injections of tirofiban on no-reflow phenomenon in patients with acute myocardial infarction during percutaneous coronary intervention ZHANG Hong-Yu1, WANG Pei-Xian2, CAO Yan-Jun1 ,WU Zhi-Guo1, LIU Han-Shu (1.Department of Cardiology, Cilinical Hospital of Baodi of Tianjin Medical University, Tianjin ,301800，China; 2. Department of Cardiology, General Hospital of Tianjin Medical University, Tianjin ,300054,China) ABSTRACT：Objective To observe the clinical effect of intracoronary injections of tirofiban on no-reflow phenomenon in patients with acute myocardial infarction (AMI) during percutaneous coronary intervention(PCI). Methods From January 2005 to September 2009, 45 patients with acute myocardial infarction who had no-reflow phenomenon during PCI were enrolled for intracoronary injections of tirofiban treatment as study groups , 49 patients with acute myocardial infarction during the same time who had no-reflow phenomenon during PCI were enrolled for intracoronary injections of verapamil treatment as control. Thrombolysis in myocardial infarction(TIMI) flow grade , corrected TIMI frame count (cTFC) and TIMI myocardial perfusion grade (TMPG) were assessed from the first contrastographic picture after drug administered and the last one at the end of PCI. R