替罗非班在急性心肌梗死介入治疗中的应用  

Application of Tirofiban for percutaneous coronary intervention in patients with acute myocardial infarction

作　　者：李卫东[1] 张国辉[1] 鲍中华[1] 真亚[1] 郭俊芳[1] 张建[1] 陈蓉[1] 王建平[1] 尹春阳[1] 王成华[1] 陶艾彬[1] 

机构地区：[1]江苏大学附属人民医院心内科,江苏镇江212002

出　　处：《江苏大学学报（医学版）》2009年第1期62-64,共3页Journal of Jiangsu University：Medicine Edition

摘　　要：目的：观察替罗非班在急性心肌梗死（AMI）经皮行冠状动脉介入治疗（PCI）中的临床价值。方法：68例急性心肌梗死行PCI患者随机分为替罗非班组（PCI＋替罗非班，28例）和对照组（PCI，40例），均于发病12 h内行急诊PCI术。PCI术前服用氯吡格雷300-600 mg，阿司匹林300 mg，术后各75 mg.d^-1，PCI术中均给予肝素8 000-10 000 U。替罗非班组PCI术中冠脉内注入盐酸替罗非班10μg.kg^-1，静脉维持量0.15μg.kg^-1.min-124~36 h。观察两组PCI术后即刻梗死相关血管（IRA）心肌梗死溶栓（TIMI分级）血流情况，术后30天内出血并发症及主要不良心脏事件（MACE）的发生情况。结果：替罗非班组TIMI 3级血流96.4%（27/28），对照组82.5%（33/40）（P〈0.05）；主要不良心脏事件的发生率替罗非班组7.1%（2/28），对照组17.5%（7/40）（P〈0.05）；出血并发症发生率两组比较无统计学意义（P〉0.05）。结论：在急性心肌梗死介入治疗中，应用盐酸替罗非班能改善急性心肌梗死患者PCI术后梗死相关血管的TIMI血流，减少PCI术后主要不良心脏事件的发生率，临床应用安全有效。Objective： To evaluate the clinical value of Tirofiban for percutaneous coronary intervention（PCI） in patients with acute myocardial infarction（AMI）.Methods： A total of 68 AMI patients were randomly divided into Tirofiban group（n=28）,and control group（n=40）.All the individuals were performed PCI within 12 hours after onset of AMI.All the individuals were given oral bolus dose of Clopidogrel 300~600 mg,Aspirin 300 mg before PCI and Clopidogrel 75 mg per day,Aspirin 75 mg per day after PCI.All the individuals were intravenous administered heparin 8 000~10 000 U during PCI.All the Tirofiban group were injected Tirofiban（10 μg·kg-1） into artery（IRA） during PCI and intravenously administered Tirofiban 24~36 hours（0.15 μg·kg-1·min-1） after PCI.The coronary TIMI flow of IRA after PCI,major adverse cardiac events（MACE） rates within 30 days,bleeding complications were analyzed and between the two groups. Results： Three degree TIMI myocardial perfusion of Tirofiban group was 96.4%（27/28）,but control group was 82.5%（33/40）（P〈0.05）.The MACE rate of Tirofiban group was 7.1%（2/28）,but control group was 17.5%（7/40）（P〈0.05）.There were no difference of complication of bleeding between the two groups（P〉0.05）. Conclusion： Application of Tirofiban intracoronary injection during primary PCI in patients with AMI was safe and effective,which may reduce the occurrence of MACE,and improve TIMI flow of IRA in patients with AMI during primary PCI.

关 键 词：替罗非班 急性心肌梗死 冠状动脉介入治疗 有效性 安全性 

分 类 号：R542.22[医药卫生—心血管疾病]