冠状动脉内注射替罗非班对急诊介入治疗中慢血流现象的临床疗效  

Curative effect of intracoronary injection with tirofiban on coronary slow flow in patients undergoing emergency PCI

作　　者：吴焱贤[1,2] 吴赛珠[1] 钟建开[3] 陈玉映[3] 霍燕嫦[3] 黎文生[3] 陈盈文[3] 麦林琳[3] 

机构地区：[1]南方医科大学南方医院心内科,广州510515 [2]顺德第一人民医院心内科 [3]南方医科大学附属顺德第一人民医院心血管内科

出　　处：《中华老年心脑血管病杂志》2013年第2期139-142,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：973项目计划(2007CB507404)

摘　　要：目的探讨冠状动脉内注射血小板膜糖蛋白Ⅱb/Ⅲa受体拮抗剂治疗急诊PCI中出现冠状动脉慢血流现象(CSF)患者的临床疗效及安全性。方法入选99例急诊PCI中出现CSF的患者,根据是否冠状动脉内注射替罗非班,分为替罗非班组44例和对照组55例;比较2组PCI术后即刻TIMI血流,术后90min完全ST段回落率、住院期间以及3个月随访LVEF、主要不良心血管事件(MACE)和出血事件。结果与对照组比较,替罗非班组术后ST段回落率明显增加(84.1%vs 65.5%,P=0.036),LVEF改善情况明显提高[(7.74±4.21)%vs(5.17±3.63)%,P=0.002],2组术后3个月MACE发生率无明显差异(P=0.466);出血事件差异无统计学意义(P=0.302)。结论急诊PCI中出现CSF情况时,冠状动脉内注射替罗非班可改善心肌灌注,加快LVEF的恢复。Objective To study the curative effect and safety of intracoronary injection with tirofi- ban,a platelet membrane glycoprotein Ⅱ b/Ⅲ a receptor antagonist, on coronary slow flow in pa- tients undergoing emergency PCI. Methods Ninety-nine patients with coronary slow flow under- going emergency PCI were divided into tirofiban treatment group（n：44） and control＇group（n： 55） according to whether they were injected with tirofiban. Their TIMI blood flow immediately after PCI and complete ST-segment resolution 90 rain after PCI,LVEF and major adverse cardiac events and bleeding in hospital and the 3-month follow-up time were compared. Results The pro- portion of ST-segment resolution and LVEF was significantly higher in tirofiban treatment group than in control group（84. 1% vs 65.5%,P=0. 036 7. 74%±4.21% vs 5. 17%±3.63%,P= 0. 002）. However, no significant difference was observed in major adverse cardiac events and bleeding between the two groups 3 months after PCI（P=0.466,P=0.302）.Conclusion Intra- coronary injection with tirofiban can improve myocardial perfusion and accelerate recovery of LVEF when coronary slow flow occurs in patients undergoing emergency PCI.

关 键 词：心肌梗死 血小板糖蛋白GPⅡb一Ⅲa复合物 冠状血管造影术 血小板聚集抑制剂 慢血流现象 替罗非班 

分 类 号：R542.22[医药卫生—心血管疾病]