机构地区:[1]北京大学第一医院心内科,北京100034 [2]包头医学院第一附属医院心内科
出 处:《中国介入心脏病学杂志》2015年第2期80-84,共5页Chinese Journal of Interventional Cardiology
摘 要:目的观察替罗非班对急性ST段抬高心肌梗死(STEMI)患者急诊经皮冠状动脉介入治疗(PCI)术后远期预后的影响。方法分析2008年1月至2010年9月行急诊PCI的急性STEMI患者228例,根据围术期是否使用替罗非班分为替罗非班组(173例)和对照组(55例)。观察两组患者住院期间和随访期间(6个月至36个月)主要不良心血管事件(MACE)的发生情况。结果替罗非班组与对照组相比,两组患者术中无复流的发生、术后即刻达到TIMI血流分级Ⅲ级、心肌染色分级(MBG)3级和心电图ST段回落大于50%的比例比较,差异均无统计学意义;两组患者住院期间总MACE、死亡、非致死性心肌梗死、计划外再次血运重建的发生率的差异均无统计学意义(P〉0.05),而替罗非班组心功能不全的发生率低于对照组(16.2%比30.9%,P=0.017)。随访期间替罗非班组总MACE(4.7%比13.5%,P=0.029)、计划外再次血运重建(3.6%比13.5%,P=0.008)和因心脏原因再住院(17.2%比30.8%,P=0.033)的发生率均低于对照组,而两组间死亡、非致死性心肌梗死发生率比较,差异无统计学意义(P〉0.05)。Cox回归分析显示使用替罗非班可降低患者远期MACE的发生率(OR 0.357,95%CI 0.130-0.985,P=0.047)。结论替罗非班具有改善急性STEMI患者急诊PCI术后远期预后的潜在作用。Objective To observe the effects of tirofiban on long-term outcomes in patients with acute ST- elevation myocardial infarction treated with primary percutaneous coronary intervention. Methods Two hundred and twenty eight patients with acute ST-elevation myocardial infarction treated with primary percutaneous coronary intervention( PCI) from January 2008 to September 2010 were enrolled in the study.The subjects were divided into two groups according to whether or not tirofiban was used during PCI procedure. Trofiban was used for patients in group A( n = 173),which was not used in group B( n = 55).The MACE rates in hospital and during the follow-up period( 6 to 36 months) were carefully calculated and compared between the two groups. Results The incidence of no reflow during the procedure,the percentage of patients with TIMI 3 flow and myocardial blush grade 3 at the end of PCI,and the percentage of patients with ST-segment resolution more than 50% were not significantly different between the two groups. The incidences of in-hospital death,of non-fatal myocardial infarction and of unplanned revascularization were not significantly different between the two groups( P 〉0. 05). The incidence of in-hospital cardiac dysfunction was significantly lower in group A than in group B( 16. 2% vs. 30. 9%,P = 0. 017). At follow up,the incidences of MACE events( 4. 7% vs. 13. 5%,P = 0. 008),unplanned revascularization( 3. 6% vs.13. 5%,P = 0. 008),and readmission with cardiac reasons( 17. 2% vs. 30. 8%,P = 0. 033),were lower in group A than in group B. The rates of death,non-fatal myocardial infarction were not significantly different between the two groups during the follow-up period( P 〉0. 05). According to Cox regression analysis,use of tirofiban was able to decrease the incidencecs of MACE during follow-up( OR 0. 357,95%CI 0. 130- 0. 985,P = 0. 047). Conclusions Tirofiban may potentially improve the long-term prognosis in patients with acute ST-elevation myocardial infarction tre
关 键 词:急性ST段抬高心肌梗死 替罗非班 急诊介入治疗 远期预后
分 类 号:R542.22[医药卫生—心血管疾病] R541.1[医药卫生—内科学]
正在载入数据...
正在载入数据...
正在载入数据...
正在载入数据...
正在载入数据...
正在载入数据...
正在载入数据...