血栓抽吸联合替罗非班在急性ST段抬高型心肌梗死急诊冠脉介入治疗中的应用  

Clinical observation of thrombus aspirated catheter combination tirofiban in primary PCI for STEMI

作　　者：苗驰[1] 金元哲[1] 周东晖[1] 柳兢[1] 姚凤臣[1] 王琦[1] 王勇[1] 

机构地区：[1]中国医科大学附属第四医院心内科,沈阳110032

出　　处：《中国实用内科杂志》2010年第6期554-555,共2页Chinese Journal of Practical Internal Medicine

摘　　要：目的评价血栓抽吸疗法联合国产替罗非班,在急性ST段抬高型心肌梗死(STEMI)急诊冠脉介入治疗(PCI)中的临床疗效及安全性。方法选择2008年6月至2009年6月因STEMI在中国医科大学附属第四医院行PCI患者102例。其中50例(A组)术前常规应用替罗非班,血栓抽吸治疗后行PCI术;另外52例(B组)术前常规应用替罗非班后完成PCI术。结果冠状动脉造影显示两组心肌灌注分级(TMP)0～1级(P=0.466)、TMP2级(P=0.142)比率差异无统计学意义;TMP3级(P=0.031)、心电图总ST段回落≥50%(P=0.026)比率A组优于B组;A组手术时间(P=0.001)、X线曝露时间(P=0.001)高于B组。术后随访半年,两组患者均无心血管事件发生。结论血栓负荷较重的STEMI患者急诊PCI中联合应用替罗非班和吸栓导管方法安全有效。Objective To evaluate the clinical effect and safety of the thrombus aspirated catheter combination Tirofiban in PCI for STEMI. Methods One hundred and two STEMI patients with total occluded IRA from June 2008 to June 2009 were divided into two groups according to the different treatments they received. Fifty patients（ group A）were intravenously administered Tirofiban as usual, and the stent was implanted after thrombus aspirated catheter was used. And the same process was applied in the other fifty-two patients （ group B） except the application of thrombus aspirated catheter. Results Coronary angiography showed that the rates of TMP 0 - 1 （ P = 0. 466 ） and TMP2 （ P = 0. 142 ） were not different in group A and B. The rate 0f TMP3 （ P = 0. 031 ） and sumSTR ≥50% （P = 0. 026） in group A was higher than in group B. The operation time （P = 0. 001 ） and the X- ray exposure time （ P = 0. 001 ） in group A were longer than in group B. During the follow-up after 6 months, the rate of major adverse cardiac events remained zero in both groups. Conclusion The thrombus aspirated catheter combination Tirofiban in PCI for thrombus burden STEMI provides better clinical effect.

关 键 词：吸栓导管 替罗非班 急性心肌梗死 冠脉介入治疗 

分 类 号：R5[医药卫生—内科学]