血栓抽吸联合冠状动脉内替罗非班对急性ST段抬高型心肌梗死患者的疗效分析  

Analysis of the effect on thrombus aspiration in combination with intracoronary tirofiban injection in patients with acute myocardial infarction

作　　者：狄红彦[1] 陈欣[2] 卢成志[2] 徐建强[2] 

机构地区：[1]天津医科大学一中心临床学院,300070 [2]天津市第一中心医院心内,300192

出　　处：《新医学》2012年第10期722-725,共4页Journal of New Medicine

摘　　要：目的:研究血栓抽吸联合冠状动脉内替罗非班对接受急诊PCI术的急性ST段抬高型心肌梗死(STEMI)患者预后的影响。方法:回顾性分析89例接受急诊PCI术的急性STEMI患者的临床资料,分析比较支架植入前行血栓抽吸后冠状动脉内注入替罗非班(A组,53例)与常规PCI后静脉应用替罗非班(B组,36例)两组的冠状动脉造影、UCG及心电图结果。结果:两组PCI术后冠状动脉造影显示的TIMI 3级血流、UCG所示的左心室舒张末期直径(LVEDd)、LVEF、术前及术后1 h心电图所示的总ST段回落≥50%比率、梗死相关血管(IRA)无复流发生率比较差异均有统计学意义。两组的住院期间主要不良心血管事件(MACE)发生率比较无统计学意义。结论:对于急性STEMI明显血栓负荷的患者,血栓抽吸联合冠状动脉内替罗非班后PCI术的治疗方案安全有效。Objective： To research the prognosis of thrombus aspiration in combination with intracoronary （IC） tirofiban injection in patients undergoing primary percutaneous coronary intervention （PCI） with acute ST- segment elevation myocardial infarction （STEMI）. Methods： Eighty-nine acute STEMI patients undergoing primary PCI were retrospectively analyzed. Patients undergoing thrombus aspiration followed by intracoronary tirofiban injection before stent implantation were defined as group A （n = 53 ）, and patients undergoing tirofiban injection intravenously after stent implantation were defined as group B （ n = 36）. The data of angiography, UCG and ECG of both groups were compared. Results： The ratio of final TIMI grade three flow, LVEDd, LVEF, and 50% resolution ratio of sum of ST- segment elevation were higher in group A than in group B, and the no-reflow incidence of IRA was lower in group A （P 〈 0. 05 ）. But there was no significant difference of hospital MACE incidence between the two groups. Conclusion： Thrombus aspiration combined with IC tirofiban is effective and safe for STEMI pa- tients undergoing primary PCI with prominent thrombus burden.

关 键 词：急性ST段抬高型心肌梗死 血栓抽吸 替罗非班 无复流 治疗时间 

分 类 号：R542.22[医药卫生—心血管疾病]