常规血小板糖蛋白Ⅱb/Ⅲa抑制剂与血栓抽吸联用预防急性心肌梗死急诊经皮冠状动脉介入治疗无复流  

Prevention of no-reflow in acute myocardial infarction patients who received primary percutaneous coronary intervention with routine Ⅱb /Ⅲa receptor antagonist associated with thrombus aspiration

作　　者：张必利[1] 陈翔[1] 徐荣良[1] 秦永文[1] 郑兴[1] 胡建强[1] 马丽萍[1] 吴弘[1] 陈少萍[1] 陈峰[1] 赵仙先[1] 

机构地区：[1]第二军医大学附属长海医院心内科,上海市200433

出　　处：《中国介入心脏病学杂志》2013年第2期80-82,共3页Chinese Journal of Interventional Cardiology

摘　　要：目的评价优化急性心肌梗死急诊经皮冠状动脉介入治疗(PCI)策略对减少术中无复流现象发生的效果。方法选择2011年6月至2012年6月第二军医大学附属长海医院心内科急性心肌梗死行急诊PCI患者165例,随机分为经验治疗组[血栓负荷重时才使用血栓抽吸装置和(或)使用血小板糖蛋白Ⅱb/Ⅲa抑制剂]和优化治疗组(无论是否血栓负荷重,均使用血小板糖蛋白Ⅱb/Ⅲa抑制剂+血栓抽吸装置)],观察两组术中无复流的发生率。结果经验治疗组和优化治疗组急诊PCI术中无复流的发生率分别为14%和1.16%(P<0.05)。优化治疗组出血并发症未见增加。结论急性心肌梗死急诊PCI优化治疗策略较经验治疗策略明显减少无复流的发生率,不增加出血并发症的风险。Objective To evaluate the effect of optimized primary percutaneous coronary intervention （PCI） treatment strategies in acute myocardial infarction patients on reduction of intraoperative ＂ no-reflow phenomenon＂. Methods 165 acute myocardial infarction patients who received primary PCI was enrolled from June 2011 to June 2012 in the department of cardiology of Changhai hospital. Patients was randomly assigned to a empirical treatment group （n = 79, thrombectomy device and （or） II b/Ilia receptor antagonist was used only when thrombus burden was heavy） or a optimized treatment group （n = 86, Ⅱ b/Ⅲ a receptor antagonist and thrombectomy device was used regardless of thrombus burden）. Incidence of noreflow were observed during PCI in both groups. Results Intraoperative no-reflow rates during PCI in empirical treatment group and optimized treatment group were 14% and 1.16%, respectively, P 〈 0.05. Bleeding complications did not increase in the optimized treatment group. Conclusions Optimized treatment strategies compared with empirical treatment strategies in acute myocardial infarction patients with primary PCI significantly reduced the incidence of no-reflow, and does not increase bleeding complications.

关 键 词：心肌梗死 血管成形术 经腔 经皮冠状动脉 无复流现象 替罗非班 

分 类 号：R541.4[医药卫生—心血管疾病]