盐酸替罗非班对急性ST段抬高型心肌梗死急诊PCI术后再灌注的影响  

Effect of Tirofiban on Reperfusion in Patients with Acute ST-segment Elevation Myocardial Infarction after Primary PCI

作　　者：何昕[1] 张翼[2] 罗海波[1] 袁旭明[1] 李沛[1] 刘智勇[1] 刘景艳[1] 

机构地区：[1]湖南省浏阳市人民医院心内科,湖南浏阳410300 [2]湖南省人民医院心内科,湖南长沙410100

出　　处：《医学临床研究》2008年第8期1406-1408,共3页Journal of Clinical Research

摘　　要：【目的】分析盐酸替罗非班对ST段抬高型心肌梗死(STEMI)患者急诊经皮冠状动脉介入术(PCI)后再灌注的影响。【方法】62例STEMI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,观察两组术后心肌缺血再灌注损伤,住院期间主要心血管事件(MACE)及安全性。【结果】试验组术后90 min心电图相关导联ST段回落幅度较对照组为大(67.03%vs 52.00%,P<0.01),肌酸激酶峰值浓度较对照组低[(1791.5±298.2)IU/L vs(2344.8±604.5)IU/L,P<0.05],术后MACE发生率较对照组低(3.1%vs 20.0%,P<0.05),心肌缺血再灌注损伤无显著性差异(56.3%vs73.3%,P>0.05),围手术期出血并发症无显著差异(15.6%vs 6.7%,P>0.05)。【结论】STEMI行急诊PCI联合应用盐酸替罗非班可改善心肌灌注,对心肌缺血再灌注损伤发生率无显著降低,安全性好。[Objective]To evaluate the effect of tirofiban on reperfusion in patients with ST-segment elevation myocardial infarction （STEMI） after primary PCI. [Methods] Sixty-two patients with STEMI who underwent primary PCI were randomly divided into two groups, i.e. the tirofiban＋ PCI group（ n = 32） and PCI without tirofiban treatment group（ n = 30）. Myocardial reperfusion, myocardial ischemia-reperfusion injury, the major adverse cardiac events （MACE） in hospital and side effects were observed. [Results] Compared with the primary PCI group, the ST-segment related derivative fell back more in patients in the tirofiban＋ PCI group （67.03% vs 52.00%, P 〈0.01）, peak creatine kinase concentrations were lower（1791.5±298.2IU/L vs 2344.8±604.5IU/L, P 〈0.05）, MACE in hospital were lower（3. 1% vs. 20.0%, P 〈0.05）, however myocardial ischemia-reperfusion injury（56.3% vs. 73.3% , P 〉0.05） and perioperative bleeding complications（15.6% vs 6.7%, P 〉0.05） had no significant difference. [Conclusion]Tirofiban combined with primary PCI can improve myocardial perfusion in patients with STEMI, and not reduce the incidence of myocardial ischemia-reperfusion injury and it is safe.

关 键 词：心肌梗塞/外科学 再灌注 

分 类 号：R542.22[医药卫生—心血管疾病]