急性ST段抬高心肌梗死直接PCI后替罗非班应用时间对中期临床预后的影响  

Effects of tirofiban application time on middle-term clinical prognosis in patients with acute ST segment elevation myocardial infarction treated by primary percutaneous coronary intervention

作　　者：顾俊[1] 胡伟[1] 肖红兵[1] 冯小弟[1] 金贤[1] 余强[1] 尹桂芝[1] 关平[1] 陈诚军[1] 陈跃光[1] 张大东[1] 

机构地区：[1]上海瑞金医院集团闵行区中心医院心内科,201100

出　　处：《中国医师进修杂志（内科版）》2008年第9期20-22,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的评价急性ST段抬高心肌梗死（STEMI）患者直接经皮冠状动脉介入治疗（PCI）后应用替罗非班时间对中期临床预后的影响。方法选择50例急性STEMI患者入院后即刻接受替罗非班治疗，直接PCI后随机分为两组：短时间组（STG，PCI后替罗非班继续使用24-36h）29例和长时间组（LTG，PCI后替罗非班继续使用48—72h）21例。记录两组患者随访6个月内主要心脏不良事件和术后6个月复查冠状动脉造影结果。结果LTG患者随访期间顽固性心绞痛的发生率为14．3％，明显低于STG患者的24．1％（P〈0．05），但两组的再狭窄率比较差异无统计学意义。结论急性STEMI患者急诊直接PCI后较长时间应用替罗非班可减少顽固性心绞痛的发生，改善中期临床预后。Objective To investigate the effects of tirofiban application time on middle-term clinical prognosis in patients with acute ST segment elevation myocardial infarction （STEMI）treated by primary percutaneous coronary intervention （PCI）. Methods The study of tirofiban was carried out in 50 patients with STEMI in cardiology department from January to December 2006. Twenty-nine patients were randomized to receive tirofiban after PCI for 24 - 36 hours（short time group, STG） and 21 patients for 48 - 72 hours （long time group,LTG）. Clinical characteristics, angiography data, main adverse cardiovascular events （MACE） and coronary restenosis rate in 6-month follow-up of the two groups were compared. Results Follow-up data showed that there was less intractable angina pectoris （ 14.3% vs 24.1%, P 〈 0.05 ） in LTG. But there was no significant difference in coronary restenosis rate between two groups. Conclusion Long time application of firofiban following PCI in patients with STEMI could improve middle-term clinical prognosis by alleviating the incidence of intractable angina pectoris.

关 键 词：心肌梗死 血管成形术 经腔 经皮冠状动脉 预后 替罗非班 

分 类 号：R542.220.5[医药卫生—心血管疾病] R973.2[医药卫生—内科学]