血栓抽吸导管联合盐酸替罗非班在急性心肌梗死患者介入治疗中的临床应用  

Effect of thrombus aspiration combined with tirofiban in primary percutaneous coronary intervention for acute myocardial infarction

作　　者：冯俊[1] 李胜友[1] 钱福东[1] 黄海涛[1] 

机构地区：[1]安徽医科大学附属六安医院,安徽六安237000

出　　处：《安徽医药》2013年第2期293-295,共3页Anhui Medical and Pharmaceutical Journal

摘　　要：目的评价血栓抽吸导管联合替罗非班治疗急性ST段抬高心肌梗死患者的临床疗效。方法选择2009年9月—2012年3月行急诊冠状动脉介入治疗(PCI)的急性ST段抬高心肌梗死患者94例,冠状动脉造影证实明显血栓负荷,其中观察组48例介入治疗前给予抽吸导管及冠状动脉内注射替罗非班,对照组46例仅行PCI术。观察临床疗效及安全性。结果治疗组在梗死血管的TIMI3级血流、术后2h ST段回落百分比、酶峰值时间均优于对照组(均P<0.05),IRA无复流/慢血流发生率低于对照组(P<0.01)。3个月时治疗组LVEF、LVEDd均优于对照组(均P<0.05)。住院期间MACE发生率治疗组低于对照组(P<0.01)。出血例数无统计学意义(P>0.05)。结论血栓抽吸导管联合盐酸替罗非班治疗急性ST段心肌梗死可减少无复流或慢血流发生,改善心肌灌注,改善预后。Objective To study the effect of thrombus aspiration combined with Tirofiban during primary PCI in patients with acute myo- cardial infarction. Methods The patients with AMI undergoing primary PCI and receiving aspiration thrombectomy catheter combined with Tirofiban（ n = 48 ）were enrolled in study group, and those who had similar coronary angiography results and basic characteristics but only received routine PCI（ n = 46）were enrolled in control group. The outcomes were observed. Results There was lower peak serum CK-MB,Tnf and faster ST segment resolution in the study group. In the study group, stent were directly implanted and TIMI flow grade 3 was obtained with all superior to the control group （ P 〈 0.05 ）, and significant difference of no-reflow/slow flow was observed between these two groups（P 〈 0.01 ）. After 3 months, LVEF and LVEDd were significantly higher in the study group than in the routine group. The total incidence rate of MACE was lower in the study group than that in the control group and the difference was significant （P 〈 0.01 ）. The incidence rate of bleeding complications was not different between two groups （ P 〉 0.05 ）. Conclusion Application of thrombus aspiration combined with tirofiban in patients with acute myocardial infarction was effective, which could decrease no-reflow/ slow flow and improve re-perfusion and result in a better clinical prognosis.

关 键 词：急性心肌梗死 经皮冠状动脉介入治疗 血栓抽吸导管 替罗非班 

分 类 号：R542.22[医药卫生—心血管疾病]