经抽吸导管冠状动脉内注射替罗非班对急诊冠状动脉介入术中无复流的疗效  

Effect of Tirofiban injection from thrombus aspirating catheter in patients with acute myocardial infarction during primary percutaneous coronary intervention with no-reflow

作　　者：付文波[1] 丁世芳[1] 陈志楠[1] 蒋桔泉[1] 龚志刚[1] 李志刚[1] 卢青[1] 

机构地区：[1]广州军区武汉总医院心内科,湖北武汉430070

出　　处：《中国介入影像与治疗学》2015年第2期70-73,共4页Chinese Journal of Interventional Imaging and Therapy

基　　金：湖北省自然科学基金(2012FFB06803);湖北省卫生厅青年人才项目(QJX201224)

摘　　要：目的评价经抽吸导管途径冠状动脉内给予替罗非班治疗急性ST段抬高心肌梗死(STEAMI)患者急诊经皮冠状动脉介入术(PPCI)中无复流现象的疗效。方法收集STEAMI接受PPCI治疗且术中发生无复流现象患者48例,均接受血栓抽吸治疗后冠状动脉内注入替罗非班,根据不同给药途径分为抽吸导管组(n=23)和指引导管组(n=25),比较两组PPCI手术结束时心肌梗死溶栓验(TIMI)试血流分级、心肌组织灌注(TMPG)分级、PPCI手术时间、术后2h心电图ST段回落比例、术后7天左心室射血分数等指标的差异。结果抽吸导管组和指引导管组术后TIMI 3级血流百分率、TMPG 3级百分率、心电图ST段回落≥50%百分率差异均有统计学意义(P均<0.05);两组PPCI手术时间、术后7天左心室射血分数差异均无统计学意义(P均>0.05)。结论在STEAMI患者PPCI术中出现无复流现象后经抽吸导管冠状动脉内注射替罗非班联合血栓抽吸治疗效果优于传统经指引导管给药途径。Objective To observe the effect of Tirofiban injection from thrombus aspirating catheter in patients with STsegment elevation acute myocardial infarction（STEAMI）during primary percutaneous coronary intervention（PPCI）with no-reflow.Methods Forty-eight patients with STEAMI during PPCI with no-reflow were injected Tirofiban to the coronary artery from thrombus aspiration catheter or guiding catheter.According to the different catheter methods,patients were divided into thrombus aspiration catheter group（n=23）and guiding catheter group（n=25）.The differences of thrombolysis in myocardial infarction（TIMI）flow grade,TIMI myocardial perfusion grade（TMPG）,PPCI operation time,proportion of postoperative ST segment fall after 2h and left ventricular ejection fraction after 7 days were compared.Results Postoperative levels TIMI 3 proportion of blood flow,TMPG 3 proportion,ST segment fell 50% were statistical deferent in two groups（all P〈0.05）.PPCI operation time and left ventricular ejection fraction after 7 days in two groups had no statistical significant（both P〉0.05）.Conclusion The effects of Tirofiban injection from thrombus aspiration catheter in patients with acute myocardial infarction during PPCI with no-reflow STEAMI patients is better than from guiding catheter.

关 键 词：替罗非班 心肌梗死 血管成形术 经验 经皮冠状动脉 血栓形成 导管 

分 类 号：R541.4[医药卫生—心血管疾病]