盐酸替罗非班联合血栓抽吸导管治疗急性心肌梗死的临床研究  

Effect of tirofiban combined with thrombus aspiration catheter therapy on patients with acute myocardial infarction

作　　者：赵宇新[1] 陈国秀[1] 秦菘[1] 边容[1] 

机构地区：[1]新疆生产建设兵团第七师医院心内科,奎屯市833200

出　　处：《北京医学》2015年第5期456-459,共4页Beijing Medical Journal

摘　　要：目的研究盐酸替罗非班联合血栓抽吸导管治疗急性ST段抬高型心肌梗死患者的临床疗效。方法选择我院2010年2月至2012年2月住院行急诊经皮冠状动脉介入(PCI)治疗的急性ST段抬高型心肌梗死患者80例,经冠状动脉造影证实为重度血栓负荷,应用盐酸替罗非班联合血栓抽吸导管治疗作为试验组,同期未应用盐酸替罗非班联合血栓抽吸导管治疗设为对照组。比较两组患者术后的心肌梗死溶栓(TIMI)血流、TIMI心肌灌注分级(TMPG)、住院期间主要心血管不良事件(MACE),并随访12个月时MACE。结果试验组TIMI血流3级(90%vs.60%,P=0.001)及TMPG 3级(87.5%vs.67.5%,P=0.009)患者显著多于对照组。两组患者院内MACE发生率比较,差异无统计学意义(2.5%vs.5.0%,P=0.473)。12个月复查造影示,试验组患者靶病变血运重建率(TLR,3.1%vs.26.7%,P=0.001)、靶血管血运重建率(TVR,6.2%vs.40.0%,P=0.001)及总MACE发生率(12.5%vs.40.0%,P=0.006)均显著低于对照组。结论盐酸替罗非班联合血栓抽吸导管治疗可以显著改善急性ST段抬高型心肌梗死患者TIMI血流、TMPG分级,降低患者术后12个月TLR、TVR及MACE的发生率。Objective To investigate the clinical effect of tirofiban combined with thrombus aspiration catheter therapy on patinents with ST-segment elevated acute myocardial infarction （STEMI）. Methods From Feb 2010 to Feb 2012, a total of 80 patients in our hospital with STEMI and thrombotic burden lesion confirmed by coronary angiography who underwent primary percutaneous coronary intervention （PCI） treatment was enrolled in this study. They were divid- ed into Patients in the experimental group received tirofiban with aspiration catheter （n=40）, the control group received no tirofiban and aspiration catheter（n=40）. Then the differences of thrombolysis in myocardial infarction （TIMI） flow grade, TIMI myocardial perfusion grade （TMPG） and major adverse cardiac events （MACE） in hospital and MACE in 12 months were compared between the two groups. Results The number of patients with grade three TIMI flow and TMPG after the therapy was larger in the experimental group than in the control group （P 〈 0.05）. MACE incidence in hospital in patients of the two groups showed no significant difference （P 〉 0.05）. The 12-months follow up showed that the rate of target lesion （TLR） or target vessel revascularization （TVR）, and the total incidence of MACE of patients in the experi- mental group were lower than those in the control group （P 〈 0.05）. Conclusion Combination of tirofiban and thrombus aspiration catheter can improve TIMI flow and TMPG grade and reduce the rate of TLR or TVR and the incidence of MACE in 12 months.

关 键 词：急性ST段抬高型心肌梗死 盐酸替罗非班 经皮冠状动脉成形术 经皮冠状动脉介入治疗 

分 类 号：R542.22[医药卫生—心血管疾病]