替罗非班对急性ST段抬高型心肌梗死患者经皮冠状动脉支架置入术后远期心功能的影响  

Effect of tirofiban on long-term heart function of patients with ST segment elevation myocardial infarction after percutaneous coronary intervention

作　　者：吕强[1] 张晓锋[1] 杜日映[1] 谢云[1] 张晓波[1] 潘立栋[1] 柴伟婷 

机构地区：[1]西安高新医院心内科,陕西西安710075

出　　处：《新乡医学院学报》2015年第3期239-241,244,共4页Journal of Xinxiang Medical University

摘　　要：目的探讨替罗非班对急性ST段抬高型心肌梗死(STEMI)患者行经皮冠状动脉支架置入术(PCI)后远期心功能的影响。方法 118例行PCI的急性STEMI患者根据术中冠状动脉内是否注射替罗非班治疗分为观察组58例和对照组60例。比较2组患者PCI情况、术后7 d及1 a心功能、术后1 a内主要心脏不良事件(MACE)及出血发生率。结果 2组患者梗死相关血管分类、临时起搏、经皮主动脉内球囊反搏术及心肌梗死溶栓试验(TIMI)梗死相关血管血流3级例数比较差异均无统计学意义(P>0.05);观察组患者校正的TIMI帧数少于对照组(P<0.05)。术后7 d,2组患者左心室射血分数、左心室收缩末期内径、左心室舒张末期内径、血清脑钠肽水平比较差异均无统计学意义(P>0.05);术后1 a,观察组患者心功能显著优于对照组(P<0.05)。术后1 a内,观察组和对照组患者MACE发生率分别为5.2%和20.0%,观察组患者MACE发生率显著低于对照组(P<0.05);观察组和对照组患者出血发生率分别为6.9%和5.0%,2组比较差异无统计学意义(P>0.05)。结论替罗非班可改善STEMI患者PCI术后远期心功能,降低MACE发生率,其机制可能与改善心肌组织微循环及减小心肌梗死面积有关。Objective To explore the effect of tirofiban on long-term heart function of patients with ST segment elevation myocardial infarction（ STEMI） after percutaneous coronary intervention（ PCI）. Methods A total of 118 patients with acute STEMI were divided into observation group（ n = 58） and control group（ n = 60） according to whether they were given tirofiban by intraoperative intracoronary injection or not. The PCI data,heart function at the seventh day and one year after PCI,major adverse cardiovascular events（ MACE） and occurrence of bleeding within one year after PCI were compared between the two groups. Results There was no significant difference in the infarction related artery classification,temporary cardiac pacing,percutaneous intra-aortic balloon counterpulsation and the cases of thrombolysis in myoxardial infarction trial（ TIMI）grade 3 of infarct related artery between the two groups（ P〉0. 05）. The corrected TIMI frames in observation group was significantly less than that in control group（ P〈0. 05）. There was no significant difference in left ventricular ejection fraction,left ventricular end-systolic dimension and brain natriuretic peptide level between the two groups on the seventh day after operation（ P〉0. 05）. One year after operation,the heart function of patients in observation group was significantly better than that in control group（ P〈0. 05）. The incidence rate of MACE in observation group and control group was 5. 2% and 20. 0% respectively within one year after operation,the incidence rate of MACE in observation group was significantly lower than that in control group（ P〈0. 05）. The incidence rate of bleeding in observation group and control group was 6. 9% and 5. 0% respectively within one year after operation,there was no significant difference in the incidence rate of bleeding between the two groups（ P〉0. 05）. Conclusion Tirofiban can improve the long-term heart function and decrease the incidence rate of MACE in patients with STEMI b

关 键 词：替罗非班 急性ST段抬高型心肌梗死 经皮冠状动脉支架置入术 心脏不良事件 

分 类 号：R542.2[医药卫生—心血管疾病]