急诊PCI冠状动脉内注射替罗非班对糖尿病合并急性心肌梗死的影响  

Effects of coronary arterial injection of tirofiban on diabetes mellitus complicated with acute myocardial infarction during primary percutaneous coronary intervention

作　　者：刘洋[1] 刘恒亮[1] 耿国英[1] 巴宁[1] 荊松宾 郭微[1] 张志芳[1] 

机构地区：[1]郑州人民医院心内科,450002

出　　处：《国际心血管病杂志》2013年第4期244-247,共4页International Journal of Cardiovascular Disease

基　　金：郑州市创新型科技人才队伍建设项目(096SYJH331144)

摘　　要：目的：探讨急诊经皮冠状动脉介入治疗（PCI）时，冠状动脉内注射替罗非班对糖尿病合并急性心肌梗死（AMI）的近期疗效和安全性。方法：选择接受急诊PCI的糖尿病合并急性ST段抬高型AMI（STEMI）患者133例，随机分为替罗非班组（n=67）和对照组（n=66）。分别对两组的临床资料、冠状动脉病变特征、住院时间和并发症的发生率进行比较。结果：替罗非班组PCI术后TIM13级血流显著高于对照组（P〈0．05），TMPG分级0～1级显著低于对照组，3级显著高于对照组（P〈0．05）。替罗非班组的平均住院天数、梗死后心绞痛、严重心律失常、KillipⅢ级以上心功能显著低于对照组；皮肤黏膜出血显著高于对照纽（P〈0．05）。结论：替罗非班能够有效地改善糖尿病合并AMI患者的TIMI血流和TMPG灌注，减少恶性心律失常、心力衰竭等严重并发症的发生，并且不增加严重出血并发症。Objective： To study the therapeutic eliect and salety oi mtracoronary administration tirofiban in patients with diabetes mellitus complicated with acute myocardial infarction （AM1） during emergency percutaneous coronary intervention （PCI）. Methods： This observational analysis wax performed on 133 diabetes patients with ST segment elevated MI who underwent emergency PCI in our department from January 2010 to October 2012. The patients were randomly divided into tirofiban treatment group （n = 67） and conventional treatment group （n = 66）. Their clinical data, coronary artery lesions, hospital stay time and complications were compared between the two groups, respectively. Results：The blood stream of coronary thrombolysis in myocardial infarction trial （TIMI） grade 3 in tirofiban treatment group was significantly higher than in conventional treatment group after emergency PC1 （P〈0. 05）. The porprotion of patients with TIMI myocardial perfusion grade （TMPG） 0- 1 in tirofiban treatment group was significantly lower than in conventional lreatrnent group after emergency PC1 （P 〈 0. 05）. While porprotion of patients with TMPG 3 in tirofihan treatment group wax significantly higher than in conventional treatment group after emergency PCI （P〈0.05）. Hospital stay time, and incidence of angina pectoris after MI, severe arrythemia and heart failure ≥ Killip III in tirofihan treatment group was significantly lowerer than in conventional treatment group alter emergency PCI （P〈0.05）. The incidence of minor bleeding in tirofiban treatment group was significantly higher than in conventional treatment group after emergency PCI （ P % 0. 05 ）. Conclusion： Intracoronaryinjection of tirofiban in diabetes patients with AMI during emergency PC1 can improve coronary flow and myocardial perfusion, and decrease the incidence of severe arrhytbmia and heart failure, with no more bleeding occurrence.

关 键 词：糖尿病 急性心肌梗死 急诊经皮冠状动脉介入治疗 替罗非班 

分 类 号：R542.22[医药卫生—心血管疾病]