替罗非班应用时机对急性ST段抬高心肌梗死急诊介入治疗的影响  

Effect of tirofiban on efficacy of emergency PCI in treatment of patient with ST-segment elevation myocardial infarction

作　　者：李国境 才江平 魏宁[3] 

机构地区：[1]宁夏煤炭总医院汝箕沟医院,石嘴山753404 [2]宁夏武警总队医院内科 [3]宁夏医科大学附属医院心脏中心心内科

出　　处：《中华老年心脑血管病杂志》2010年第11期987-989,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的观察早期应用替罗非班对急性ST段抬高心肌梗死(STEMI)急诊PCI效果的影响。方法将发病<12 h急诊PCI的STEMI患者240例随机分为早期组(冠状动脉造影前1～3 h应用替罗非班)和即刻组(冠状动脉造影后即刻应用替罗非班),每组120例。观察2组PCI前后TIMI血流分级和梗死区心肌灌注(TMP)分级,PCI后30 d主要不良心血管事件(MACE)情况。结果与即刻组比较,早期组PCI前TIMI 3级血流和TMP 3级比例明显升高(30.8% vs 10.8%,33.3% vs 12.5%,P<0.05);早期组PCI后TMP 3级明显升高(77.5% vs 51.7%,P<0.05)。早期组发生MACE 3例,即刻组4例(2.5% vs 3.3%,P>0.05)。结论对STEMI急诊PCI的患者,早期应用替罗非班能改善梗死相关血管的血流及心肌灌注。Objective To evaluate the effect of early tirofiban on efficacy of emergency percutaneous coronary intervention（PCI） in treatment of patients with STEMI. Methods 240 patients with acute STEMI were enrolled and divided into two groups, early group, tirofiban was given 1- 3 hours before coronary arteriography（CAG）;immediate group：tirofiban was given immediately after CAG. All patients underwent emergency PCI within 12 hours after onset of disease. The coronary TIMI flow and TMP of infarct-related artery（IRA） were graded before and after PCI,major adverse cardiac events（MACE） within 30 days and bleeding complication were observed. Results The proportions of TIMI 3 and TMP 3 in early group before PCI were higher than those in immediate group （30.8% vs 10.8% ,33. 30% vs 12. 5%, P 〈0. 05） ,the proportion of TMP 3 in early group after PCI was higher than that in immediate group（77.5% vs 51.7%）,the difference between the two groups was significant （P 〈 0.05）. Three cases had MACE in early group while 4 cases in immediate group（2.5 % vs 3.3%, P 〉0. 05）. Conclusion Early tirofiban administration can improve the coronary TIMI flow and myocardial perfusion of IRA in patients with STEMI undergoing emergency PCI.

关 键 词：血小板聚集抑制剂 心肌梗死 血管成形术 经腔 经皮冠状动脉 心电描记术 

分 类 号：R542.22[医药卫生—心血管疾病]