血栓抽吸导管联合半量替罗非班在老年急性ST段抬高型心肌梗死患者中的应用  

Clinical application of thrombus suction catheter combined with half dose of Tirofiban in older patients with acute STEMI

作　　者：王慧[1] 党群[2] 

机构地区：[1]天津医科大学研究生院,天津300070 [2]天津市南开医院心内科,天津300100

出　　处：《天津医科大学学报》2012年第3期339-341,345,共4页Journal of Tianjin Medical University

摘　　要：目的:对血栓抽吸导管联合半量替罗非班治疗老年急性ST段抬高型心肌梗死的安全性及有效性进行评价。方法:92例急性ST段抬高型心肌梗死患者,平均年龄(68.39±12.22)岁,术前TIMI血流0-1级,随机分为常规经皮冠状动脉介入治疗(PCI)组(对照组)30例,半量替罗非班组(A组)31例,抽吸导管联合半量替罗非班组(B组)31例,比较3组术后TIMI血流分级,术后心肌灌注分级(TMP),术后2 h心电图回落百分比(SumSTR),左室射血分数(LVEF),左室舒张末内径(LVEDD)及住院期间和术后3个月主要心血管不良事件的发生率和出血并发症等。结果:对于患者术后TIMI血流3级、TMP3、术后SumSTR>70%及LVEF等指标,A、B两组显著高于对照组(P<0.05),且B组显著高于A组(P<0.05);3组之间术后出血事件及3个月主要心脏不良事件无显著差别(P>0.05)。结论:血栓抽吸导管联合半量替罗非班治疗老年急性ST段抬高型心肌梗死有效、安全,即刻血流恢复良好,术后无复流事件少,实现了心肌真正意义上的再灌注。Objective： To investigate the clinical safety and efficacy of thrombus aspiration catheter combined with half dose of Tirofiban therapy on older patients with acute ST-segment elevation myocardial infarction（STEMI）.Methods： A total of 92 STEMI patients[mean age：（68.39±12.22）years]were randomly divided into routine PCI group（n=30）,semis tirofiban group（group A,n=31）and semis tirofiban ＋thrombus aspiration group（group B,n=31）.Analyses were performed on thrombolysis in myocardial infarction（TIMI）,TIMI myocardial perfusion grade（TMP）,elevated ST segment resolution rate（SumSTR）,left ventricular ejection fraction（LVEF）,end-diastolic left ventricular diameter（LVEDD）,major adverse cardivascular events（MACE）and ratios of bleeding within three months after PCI.Results： Compared with routine PCI group,the number of group A and group B patients with TIMI3,TMP3,SumSTR70% and LVEF were larger（P0.05）,and group B was significantly larger than group A（P0.05）.Incidence rates of MACE and bleeding events showed no significance within three months after PCI therapy among the three groups（P0.05）.Conclusion： Combined application of thrombus aspiration catheter and half dose of Tirofiban is effective and safe.The instant blood flow of this therapy is better.The rate of no-reflow phenomenon is lower.This treatment can realize the really myocardial reperfusion.

关 键 词：急性ST段抬高型心肌梗死 经皮冠状动脉介入治疗 血栓抽吸 替罗非班 老年 

分 类 号：R542.2[医药卫生—心血管疾病]