替罗非班在急性ST段抬高型心肌梗死急诊PCI治疗中的作用  

Tirofiban in emergency percutaneous coronary intervention of acute ST-elevation myocardial infarction

作　　者：龙盼[1] 张俊峰[1] 王瑾[1] 周军[1] 郭华[1] 俞晓雯[1] 张田田[1] 

机构地区：[1]上海交通大学医学院附属第三人民医院心内科,201900

出　　处：《中国循证心血管医学杂志》2011年第5期356-358,共3页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的探讨在冠状动脉介入术(PCI)前开始使用盐酸替罗非班对急性ST段抬高型心肌梗死(STEMI)患者心肌再灌注的疗效。方法入选84例STEMI患者,根据是否有胸痛症状分为替罗非班组(n=61)和对照组(n=23)。对照组给予阿司匹林、氯吡格雷常规药物治疗,替罗非班组在常规治疗基础上加用盐酸替罗非班治疗,观察替罗非班对患者冠状动脉血流、PCI术后1hST段回落、CK-MB峰值及出血副作用的影响。结果支架置入术前替罗非班组TIMI1级血流发生率及支架置入术后TIMI3级、2级血流发生率均优于对照组(P均<0.05)。两组CK-MB峰值、PCI术后1hST段完全回落率比较,均有统计学差异(P均<0.05)。替罗非班组和对照组发生轻微出血的比率分别为29.51%、8.70%,差异有统计学意义(P<0.05)。结论替罗非班能改善支架置入前后的TIMI血流,有利于缺血心肌的再灌注,但同时增加轻微出血的风险。Objective To discuss the curative effect of tirofiban on myocardial reperfusion used before percutaneous coronary intervention（PCI）in the patients with acute ST-elevation myocardial infarction（STEMI）.Methods STEMI patients（n=84） were divided into the tirofiban group（n=61） and control group（n=23） according to whether they had chest pain.The control group was given aspirin and clopidogrel,and the tirofiban group,tirofiban besides routine treatment.The influences of tirofiban on coronary blood flow,ST-segment resolution after PCI for one hour,CK-MB peak value and bleeding were observed.Results The occurrence of TIMI grade 1 flow before PCI,and occurrence of TIMI grade 3 and 2 after PCI in the tirofivan group were superior to those in the control group（all P0.05）.The comparisons in CK-MB peak value and ST-segment full resolution rate one hour after PCI between two groups showed statistical differences（all P0.05）.The percentage of mild bleeding was 29.51% in the tirofiban group and 8.70% in the control group and the difference was statistically significant（P0.05）.Conclusion Tirofiban can improve TIMI flow before and after PCI and is helpful to reperfusion of ischemia myocardial,but increases the risk of mild bleeding.

关 键 词：替罗非班 心肌梗死 心肌再灌注 经皮冠状动脉介入术 

分 类 号：R541.4[医药卫生—心血管疾病]