冠状动脉内注射替罗非班对急诊冠状动脉介入术中无再流的作用  

Effects of intracoronary administration of tirofiban in acute myocardial infarction patients with no reflow phenomenon after primary percutaneous coronary intervention

作　　者：朱强 刘福元 黎晓兰 朱磊 骆峰 李晓妹 李静 陆莉 

机构地区：[1]湖北襄樊市第一人民医院心内科,湖北襄樊441000

出　　处：《临床心血管病杂志》2011年第1期22-25,共4页Journal of Clinical Cardiology

摘　　要：目的:评价血小板Ⅱb/Ⅲa受体拮抗剂替罗非班经冠状动脉注射对急性ST段抬高型心肌梗死(STEMI)患者急诊经皮冠状动脉介入(PCI)治疗后无再流的疗效。方法:STEMI急诊经皮经腔冠状动脉成形术/支架置入术梗死相关动脉再通后存在无再流现象50例。2005-01-2007-10,20例冠状动脉内注射硫氮唑酮(0.5～2.0mg),2007-11-2010-03,30例冠状动脉内注射替罗非班(0.5～1.0mg);注射完后10min行冠状动脉造影,评定冠状动脉血流TIMI分级。结果:硫氮唑酮组应用后20～40min内TIMI血流3级10例,TIMI血流0～2级10例;替罗非班组应用后20～40min内TIMI血流3级24例,TIMI血流0～2级6例。达TIMI3级患者替罗非班组多于硫氮唑酮组(P<0.05)。结论:经冠状动脉给予替罗非班(0.5～1.0mg)后能有效改善急诊PCI术中无再流现象。Objective：To assess the effects of intracoronary administration of tirofiban in the patients with acute ST-elevation myocardial infarction（STEMI） that had no reflow phenomenon of infarct related artery（IRA） after primary percutaneous transluminal coronary angioplasty or/and intracoronary stenting.Method：We studied 50 AMI patients with no reflow phenomenon of IRA after emergent PCI between January 2005 and March 2010.Diltiazem treated group（n=20） was given intracoronary diltiazem 0.5～2.0 milligram with 10～30 minutes between January 2005 and October 2007,while tirofiban treated group（n=30） was given intracoronary tirofiban 0.5～1.0 milligram with 10～30 minutes between November 2007 and March 2010.Ten minutes after administration,coronary arteriography（CAG） was performed and thrombolysis in myocardial infarction（TIMI） flow grade was measured.Result：50% of patients in the diltiazem treated group reached TIMI flow grade 3 within 20～40 minutes;80% of patients in the tirofiban treated group reached TIMI flow grade 3.The percentage of the patients who reached TIMI flow grade 3 after the intracoronary administration was significantly higher in the tirofiban treated group as compared to diltiazen treated group（P0.05）.Conclusion：The intracoronary administration of tirofiban 0.5～1.0 milligram can effectively improved the no reflow phenomenon after primary PCI in patients with STEMI.

关 键 词：ST段抬高心肌梗死 替罗非班 硫氮唑酮 冠状动脉介入治疗 无再流 

分 类 号：R542.22[医药卫生—心血管疾病]