冠脉内应用替罗非班在急性心肌梗死急诊介入术中的近期疗效评价  

Evaluation of short-term effect of application of tirofiban in intracoronary emergency intervention in patients with acute myocardial infarction

作　　者：汪坤[1] 吴方斌[1] 周杰[1] 朱春甲[1] 

机构地区：[1]铜陵市人民医院心血管内科,安徽铜陵244002

出　　处：《医药论坛杂志》2011年第23期82-84,共3页Journal of Medical Forum

摘　　要：目的评价冠脉内应用替罗非班在急性心肌梗死急诊介入术中的近期疗效。方法 2008年1月至2011年9月在铜陵市人民医院心内科收治的STEMI并需进行PCI治疗的患者59例,按自愿的原则将患者分为对照组29例和观察组30例。对照组常规PCI治疗,观察组在常规治疗的同时术前静脉输注替罗非班,起始30min内滴注速率为0.4μg/(kg.min),起始输注量完成后,继续以0.1μg/(kg.min)的速率维持输注,术后静脉输注盐酸替罗非班0.15μg/(kg.min)持续36～48h。观察PCI前后TIMI血流、校正的TIMI计帧数(CTFC)、评价左室射血分数(LVEF)、住院期间主要出血并发症和术后6个月主要心血管事件(major adverse cardiovascular event,MACE)发生率。结果两组治疗前后TIMI、CTFC及LVEF均有改善,但观察组改善情况明显好于对照组,两组比较差异有统计学意义(P<0.05)。两组术后1周出血并发症比较无统计学意义(P>0.05);两组术后6个月心血管事件发生率对照组高于观察组,差异有统计学意义(P<0.05)。结论替罗非班可改善急性冠状动脉综合征介入治疗后的无复流和慢血流,提高TIMI 3级血流,并能改善心肌灌注和左室收缩功能,且不增加患者住院期间主要并发症的发生。Objective To evaluate the short-term effectint of racoronary application of tirofiban in patients with acute myocardial infarction intervention.Methods 35 January 2008 to September 2011 Cardiology in our hospital and admitted with STEMI treated with PCI in patients in need of 59 cases according to the principle of voluntary patients were divided into control group 29 cases and 30 cases observed.PCI Conventional treatment control group,observed in the conventional treatment group,while preoperative intravenous infusion of tirofiban,starting 30 minutes infusion rate of 0.4μg/（kg·min）,after the initial transfusions,continue to 0.1ug/（kg·min） to maintain the rate of infusion,after intravenous infusion of tirofiban hydrochloride 0.15μg/（kg·min） sustained 36 to 48 hours.Observed before and after PCI TIMI flow,corrected TIMI frame count（CTFC）,evaluation of left ventricular ejection fraction（LVEF）,major bleeding complications during hospitalization and after 6 months of major cardiovascular events（major adverse cardiovascular event,MACE） incidence.Results Before and after treatment TIMI,CTFC and LVEF were improved,but the observation group improved significantly better than the control group,the difference was statistically significant（P0.05）.Two groups after 1 week of bleeding complications was not statistically significant（P0.05）;two groups after 6 months the incidence of cardiovascular events in the observation group than that of the control group,the difference was statistically significant（P0.05）.Conclusions Tirofiban intervention to improve treatment of acute coronary syndrome after the no-reflow and slow flow,TIMI 3 improve blood flow,and improve myocardial perfusion and left ventricular systolic function,without increasing the main period of hospitalization the incidence of complications.

关 键 词：心肌梗死 替罗非班 介入 

分 类 号：R542.22[医药卫生—心血管疾病]