抽吸导管联合替罗非班冠脉内注射在急性ST段抬高型心梗中的应用  

Effects of thrombus aspiration plus Tirofiban on myocardial reperfusion in patients with acute myocardial infarction treated by primary percutaneous coronary intervention

作　　者：张立博 苏仁芳 陈德超 关丽卿 周杰良 吴咏豪 付熠 宾冬梅 

机构地区：[1]东莞市常平人民医院心内科,广东省523573

出　　处：《中国心血管病研究》2012年第2期131-134,共4页Chinese Journal of Cardiovascular Research

摘　　要：目的 评价在血栓抽吸前、后冠脉内注射替罗非班对急性心肌梗死患者心肌再灌注的影响及预后。方法选取2009年9月至2011年6月在我院行急诊PCI治疗的急性sT段抬高型心梗患者103例，随机分为两组。A组在造影术后立即冠脉内注射替罗非班，B组在血栓抽吸术后冠脉内注射替罗非班，评价PCI术后两组患者造影结果及左室射血分数（LVEF）、MACE情况。结果A组心肌呈色分级（MBG）2-3级的比例为86．2％，而B组的比例为69．1％，差异具有统计学意义。出院前A、B两组LVEF值分别为（70．5±10．0）％和（61．5±11．0）％。冠脉内TIMI3级血流、CTFC帧数及sT段回落率两组比较差异无统计学意义。结论在急性ST段抬高型心肌梗死患者行PCI时，如果患者血栓负荷过重，先行冠脉内替罗非班注射然后再进行血栓抽吸，可以得到更好的心肌再灌注，并且对LVEF的改善有益。Objective To investigate the effects of thrombus aspiration plus Tirofiban on myocardial reperfusion in patients with STEMI treated by primary percutaneous coronary intervention （PCI）. Methods 103 patients with primary STEMI who underwent primary PCI were randomized into two groups. One group was treated with Tirofiban intracoronary injection before thrombus aspiration while another group were treated with Tirofiban intracoronary injection after thrombus aspiration. Angiography of criminal artery, LVEF and MACE between the two groups were compared. Results A myocardial blush grade of 2 to 3 after PCI occurred in 86.2% of the patients receiving Tirofiban intracoronary injection before thrombus aspiration and in 69.1% in the patients receiving Tirofiban intracoronary injection after thrombus aspiration （P〈0.05）, LVEF values before discharge were （70.5±10.0）% and （61.5±11.0）% respectively, whereas the CTFC, TIMI-3 coronary artery blood flow. Resolution of ST-segment elevation and MACE were the same between the two groups. Conclusion Intracoronary injection of Tirofiban before thrombus aspiration might lead to better myocardial reperfusion, LVEF and even prognosis.

关 键 词：心肌梗死 经皮冠状动脉介入治疗 血栓抽吸 替罗非班 

分 类 号：R542.2[医药卫生—心血管疾病]