强化抗血小板治疗对急性ST段抬高心肌梗死急诊经皮冠状动脉介入术后QT离散度影响的临床研究  

Impacts of intensive antiplatelet treatment on Q-T dispersion after successful percutaneous coronary intervention of ST segment elevation myocardial infarction

作　　者：何昕 罗海波 袁旭明 李沛 刘智勇 刘景艳 HE Xin, LUO haibo, YUAN xuming, FENG huiliang, LIU zhiyong, LIU jingyan （1. Department of Cardiology, People Hospital of LIU YANG city, Liuyang. 410300, China）

机构地区：湖南省浏阳市人民医院,410300

出　　处：《中外健康文摘：医药月刊》2008年第7期563-565,共3页

摘　　要：目的分析Ⅱb／Ⅲa受体拮抗剂盐酸替罗非班对ST段抬高型心肌梗死（STEMI）患者急诊经皮冠状动脉介入治疗（PCI）术后QT离散度的影响。方法62例STEMI患者随机分为实验组32例和对照组30例，实验组在PCI基础上加盐酸替罗非班、对照组直接PCI，观察两组术后的心肌再灌注，术前、术后即刻、术后6小时、24小时QT离散度。结果试验组术后90分钟心电图相关导联ST段回落幅度较对照组大（67．03％ vs 52．00％，P=0．OO），肌酸激酶峰值浓度较对照组低（1791．5±298．2IU／L VS 2344．8±604．5IU／L，P=0．03），术后24小时QT离散度降低敲对照组明显（45．1±11．1vs51．5±10.8，P=0．03）。结论STEMI行急诊PCI联合应用盐酸替罗非班可改善心肌灌注，显著降低术后QT离散度。Objective The purpose of the study was to seek whether glycoprotein IIb/IIIa （GP IIb/IIIa） inhibition has additional beneficial effects on QT dispersion after angiographically successful PCI. Methods The study involved 62 consecutive patients. 30 patients were randomized to receiye standard therapy including preprocedural aspirin, ticlopidine, and IV heparin, and 32 patients were randomized to receive additional IV tirofiban infusion before the lesion was crossed with the guidewire. Standard 12-lead simultaneous ECG recordings for the measurement of QTd was obtained before and immediately after the procedure, and at the 6th, and 24th hours, the myocardial reperfusion after the procedure . Result Compared with the primary the standard therapy group, the extent of ST segment Resolution after PCI in tirofiban group was low （67.03%vs 52.00%, P=0.00） ,peak creatine kinase concentrations was low （1791.5±298.2IU/L vs 2344. 8±604. 5IU/L, P=0. 03 ） , QTd at the 24th after procedure was significant low （45.1±11.1 vs 51.5±10.8, P=0.03） .Conclusion Tiroflban combined with primary PCI can improve myocardial perfusion in patients with SIEMI, significant reduce the QTd.

关 键 词：盐酸替罗非班 心肌梗死 介入治疗 QT离散度 

分 类 号：R541[医药卫生—心血管疾病;医药卫生—临床医学;医药卫生—内科学]