冠状动脉内注射替罗非班或尿激酶治疗急性STEMI患者PCI术中无复流或慢血流的对比研究  

Comparative efficacy of intracoronary tirofiban versus urokinase on no-reflow or slow flow in patients with STEMI undergoing primary PCI

作　　者：姜海兵[1] 李岚[1] 李秀芬[1] 帕不哈提.吐不逊 杨毅宁[2] 姜述斌[1] 

机构地区：[1]新疆医科大学附属中医医院心脏中心CCU,乌鲁木齐830000 [2]新疆医科大学第一附属医院心脏中心

出　　处：《临床心血管病杂志》2013年第10期750-752,共3页Journal of Clinical Cardiology

摘　　要：目的:观察急性ST段抬高性心肌梗死(STEMI)直接经皮冠状动脉(冠脉)介入治疗(PCI)中,通过导管冠脉内注射替罗非班或尿激酶对无复流或慢血流患者的梗死相关血管TIMI血流分级和校正的TIMI血流帧数计数(CTFC)的影响。方法:51例直接PCI术中出现无复流或慢血流的STEMI患者随机冠脉内给予替罗非班(治疗组,28例)或尿激酶(对照组,23例),于给药后3min及8min时复查造影,观察两组梗死相关血管的TIMI分级和CTFC、出血并发症和30d主要心血管事件(MACE)。结果:给药后3min及8min两组TIMI分级与CTFC均较给药前显著好转,给药后3min两组间差异无统计学意义;治疗组给药后8min较3min时TFG、CTFC进一步好转,对照组有恶化趋势(P<0.05)。两组术后出血并发症和30dMACE发生率差异无统计学意义。结论:对于STEMI患者直接PCI术中无复流或慢血流,冠脉内注射替罗非班较尿激酶可更有效改善冠脉血流。Objective： To observe the effects of flow grade and corrected TIMI frame count （CTFC） tirofiban and urokinase by intracoronary injections on TIMI in patients with acute ST-segment elevation myocardial infarc- tion （STEMI） with no-fellow or slow flow phenomenon during percutaneous coronary intervention （PCI）. Method：Fifty-one patients with STEMI and no re{low or slow flow after PCI were divided into treatment group （n=28） and control group （n = 23）, and the fomer were given tirofiban by intracoronary, while the later were given urokinase. TIMI flow grade, CTFC, bleeding complications and 30 days of major cardiovascular events were observed by coronary arteriongraphy after 3 and 8 minutes of injection. Result：TIMI flow grade and CTFC in both groups improved significantly after treatment, but there was no significant difference between two groups after 3 minutes. In the treatment group, TIMI flow grade and CTFC after 8 minutes were further improved than 3 minutes, while the control group were deterioration. There were no significant difference of bleeding complications and 30 days MACEs between two groups. Coclusion： Intracoronary tirofiban could effectively improve coronary blood flow than urokinase in patients with STEMI during PCI.

关 键 词：心肌梗死 慢血流 无复流 替罗非班 尿激酶 

分 类 号：R542.2[医药卫生—心血管疾病]