女性急性心肌梗死患者应用替罗非班的研究  

Effect of tirofiban administration for female acute myocardial infarction patients

作　　者：高远[1] 李玉泽[1] 关启刚[1] 张海山[1] 郭亮[1] 田文[1] 贾大林[1] 张月兰[1] 孙英贤[1] 齐国先[1] 

机构地区：[1]中国医科大学附属第一医院心血管内科,辽宁沈阳110001

出　　处：《武警后勤学院学报（医学版）》2013年第5期366-369,共4页Journal of Logistics University of PAP（Medical Sciences）

摘　　要：【目的】评估ST段抬高急性心肌梗死女性患者急诊介入术中应用替罗非班效果。【方法】连续入选167例女性ST段抬高急性心肌梗死患者,随机分配替罗非班组84名[冠脉造影后经静脉内注射替罗非班负荷量10μg/kg,随即0.15μg.(kg.min)-1静脉滴注维持24 h,对照组83名(给予盐水静脉滴注24 h对照)]。观察两组患者"罪犯"冠脉血管冠脉血流,术后心肌坏死标志物峰值,心功能及术后180 d不良心脏事件的发生率。【结果】与对照组相比,替罗非班组冠脉血流改善明显[血流校正的TIMI帧数(corrected TIMI frame count,CTFC):(18.11±7.67)比(26.89±8.13),P=0.019];术后7 d替罗非班组患者超声检查射血分数明显优于对照组([50.03%±7.43%)比(41.01%±8.39%),P=0.041];心肌坏死标志物峰值替罗非班组明显低于对照组;术后180 d不良心脏事件发生率,替罗非班组低于对照组(11.90%比25.30%,P=0.025)。【结论】女性ST段抬高急性心肌梗死患者急诊介入治疗术中,应用替罗非班可提高冠脉血流灌注,改善术后心功能,减少心肌梗死面积,减少术后180 d不良心脏事件发生率。【Objective】To assess the effect of tirofiban administration during emergency percutaneous coronary intervention for female ST-segment elevation acute myocardial infarction（STEMI） patients.【Methods】A total of 167 female STEMI patients were involved in this study.84 patients were randomly assigned to tirofiban group（tirofiban as an intravenous bolus dose of 10 μg/kg,followed by an intravenous infusion of 0.15 μg.（kg.min）-1up to 24 h.83 patients were assigned to control group（saline control intravenous for 24h）.Corrected TIMI frame count（CTFC） of the＂culprit ＂ coronary artery coronary,peak values of postoperative myocardial necrosis markers and the MACE of 180 d between the two groups were compared.【Results】CTFC and post-operative left ventricular ejection fraction in tirofiban group were improved[CTFC ：（18.11±7.67） vs.（26.89±8.13）,P = 0.019;EF：（50.03%±7.43%）vs（41.01%±8.39%）,P = 0.041].Myocardial necrosis markers peak values were significantly lower than control group.The postoperative incidence of 180 d major adverse cardiovascular events（MACE） in tirofiban group were lower（11.90% vs.25.30%,P =0.025）.【Conclusions】Our results showed that tirofiban administration in female patients with STEMI during emergency PCI could improve coronary perfusion,improve cardiac function,reduce myocardial infarctsize and improve their 180 d progonosis.

关 键 词：急性心肌梗死 血管成型术 替罗非班 女性 

分 类 号：R459.6[医药卫生—治疗学]