国产替罗非班在急性心肌梗死患者经桡动脉入径行直接冠状动脉介入治疗术中的应用  

Application of domestic tirofiban for undergoing transradial artery access for primary percutaneous coronary interventional therapy in patients with acute myocardial infarction

作　　者：敖钦 马进[1] 王新旺[1] 殷锡虎 罗云[1] 

机构地区：[1]江西省九江市第一人民医院心血管内科,江西九江332000

出　　处：《中国现代医生》2013年第32期68-69,72,共3页China Modern Doctor

摘　　要：目的探讨国产替罗非班在急性心肌梗死患者经桡动脉入径行直接冠状动脉介入治疗术中的有效性和安全性。方法将100例接受直接PCI治疗的急性心肌梗死患者随机分为两组,观察组接受国产替罗非班治疗,对照组采用生理盐水静滴,比较两组PCI术后即刻结果和不良事件发生率。结果观察组TIMI 3级获得率96%,与对照组相比(88%)差异无统计学意义(P>0.05);观察组CTFC为(22.9±5.8)帧数,低于对照组(30.9±12.5)帧数,差异有统计学意义(P<0.05);Blush分级观察组3级获得率68%,与对照组(28%)相比,差异有统计学意义(P<0.05);观察组肌酸激酶峰浓度(1 856.5±320.6)IU/L低于对照组(2 315.5±624.6)IU/L,差异有统计学意义(P<0.05);观察组90 min心电图ST段下降幅度(66.9±14.9)%大于对照组(40.5±11.6)%,差异有统计学意义(P<0.05);两组术后1周左心室射血分数差异无统计学意义(P>0.05);两组患者主要心血管事件发生率和并发症发生率差异无统计学意义(P>0.05)。结论在急性心肌梗死患者经桡动脉入径行直接冠状动脉介入治疗术中应用国产替罗非班可以改善术后冠脉血流和心肌灌注,疗效安全可靠。Objective To explore the domestic tirofiban in patients with acute myocardial inthrction undergoing tran- sradial artery access for primary coronary the effectiveness and safety of intraoperative intervention. Methods A total of 100 patients with acute myocardial infarction undergoing primary PCI therapy were randomly divided into two groups, the observation group received domestic for tirofiban treatment, the control group using saline infusion, the im- mediate results and the incidence of adverse events were compared between the two groups after PCI. Results In the observation group, TIMI 3 level was 96%, compared with the control group （88%） had no significant difference （P〉 0.05）. CTFC of observation group was （22.9_＋5.8） frame count,lower than the control （30.9_＋12.5）, the difference was statistically significant （P〈0.05）. The level 3 rate of blush grading in observation group was 68%, significantly higher than that in control group （28%）, had statistically significant difference （P〈0.05）. Creatine kinase concentration in ob- servation group was （1 856.5_＋320.6） IU/L, lower than the control group （2 315.5_＋624.6） IU/L, the difference was sta tistieally significant （P〈0.05）, 90 min ST segment of ECG decreased （66.9_＋14.9）% in observation group than that of the control （40.5＋11.6）%, the difference was statistically significant （P〈0.05）,there were no significant difference of left ventricular ejection fraction after operation 1 week in the two groups （P〉0.05）, two major cardiovascular events in- cidence rate and complication rates were not statistically significant （P〉0.05）. Conclusion Patients with acute myocar- dial infarction undergoing transradial artery access for primary percutaneous coronary domestic tirofiban can improve the postoperative coronary blood flow and myocardial perfusion in patients with curative effect, safe and reliable.

关 键 词：急性心肌梗死 替罗非班 冠状动脉介入治疗术 

分 类 号：R542.22[医药卫生—心血管疾病]