早期应用替罗非班对ST段抬高型心肌梗死患者急诊冠状动脉介入术后心肌微循环再灌注的影响  

Early use of tirofiban on percutaneous coronary intervention myocardial microcirculation after reperfusion in patients with ST-segment elevation myocardial infarction

作　　者：李莺[1] 贺铿[1] 石刚[1] 

机构地区：[1]萍乡市人民医院心血管内科,江西萍乡337055

出　　处：《临床荟萃》2013年第8期866-867,871,共3页Clinical Focus

摘　　要：目的观察临床早期应用替罗非班对ST段抬高型心肌梗死患者急诊介入术后再灌注及心功能的影响。方法 70例ST段抬高型心肌梗死患者随机分为研究组(35例)和对照组(35例),研究组在急诊介入术基础上加用替罗非班,而对照组只采取急诊介入术,然后观察两组患者心肌缺血再灌注损伤,住院期间主要心血管事件。结果研究组术后90分钟心电图相关导联ST段回落幅度明显大于对照组,肌酸激酶峰值浓度明显低于对照组,(1 657.52±326.14)U/L vs(2 519.83±459.76)U/L(P<0.01),血管终末段显影祯数少于对照组,(18.12±4.34)祯vs(23.33±5.45)祯(P<0.01),ST段下移程度比显示末端血管灌注优于对照组(68.14±12.57)%vs(53.20±11.14)%(P<0.05)。结论急诊PCI联合应用替罗非班治疗ST段抬高型心肌梗死患者可改善心肌的灌注,明显降低心肌缺血再灌注损伤的发生率。Objective To evaluate the effects of tirofiban on reperfusion in patients with ST-segment elevation myocardial infarction（STEMI） after primary percutaneous coronary intervention（PCI）.Methods Seventy patients with STEMI who underwent primary PCI were randomly divided into two groups,tirofiban＋ PCI group（n=35） and PCI without tirofiban group（control group,n=35）.Myocardial reperfusion,myocardial ischemia-reperfusion injury,the major adverse cardiac events（MACE） in the hospital and side effects were observed.Results 90 minutes after the operation,ECG ST-segment elevation in tirofiban＋ PCI group was much greater than that of control group,peak creatine kinase concentration significantly lower than that of control group,（1 657.52±326.14） U/L vs（2 519.83±459.76） U/L（P0.01）,the number of developed frame of terminal vessel was lower than that of control group,（18.12±4.34） frame numbers vs（23.33±5.45） frame numbers（P0.05）,the end of the vascular perfusion was superior over control group（68.14±12.57） % vs（53.20±11.14）%（P0.05）.Conclusion Tirofiban combined with primary PCI can improve myocardial perfusion in patients with STEMI,and reduce the incidence of myocardial ischemia-reperfusion injury.

关 键 词：心肌梗死 血管成形术 经腔 经皮冠状动脉 替罗非班 再灌注 

分 类 号：R542.22[医药卫生—心血管疾病]