急诊PCI术前静脉应用替罗非班联合术中冠脉内小剂量给药的临床研究  

Clinical research of preoperative tirofiban combined with intraoperative small dose intracoronary administration in emergency PCI surgery

作　　者：彭庚[1,2] 谢文燕[1,2] 刘东亮[1,2] 董艳彩[1,2] 胡新荣[1,2] 

机构地区：[1]漯河医学高等专科学校第一附属医院 [2]漯河市中心医院心内科,462000

出　　处：《中国实用医药》2015年第15期6-8,共3页China Practical Medicine

摘　　要：目的探讨急诊经皮冠状动脉介入治疗(PCI)术前静脉应用替罗非班联合术中冠脉内小剂量给药的疗效和安全性。方法 102例行急诊PCI的急性ST段抬高型心肌梗死(STEMI)患者,随机分为研究组(52例)和对照组(50例)。研究组术前应用替罗非班,对照组术前未应用。比较两组梗死相关动脉(IRA)自发再通率,PCI术中慢血流、无复流发生率,术后7 d主要心血管事件(MACE)及出血事件发生率。结果研究组介入治疗前冠脉造影提示IRA自发再通率高于对照组,术中慢血流、无复流的发生率要低于对照组,组间比较,差异有统计学意义(P<0.05);研究组术后7 d的MACE事件的发生率低于对照组,但差异无统计学意义(P>0.05)。两组均未发生严重出血事件。结论急诊PCI术前静脉应用替罗非班联合术中冠脉内小剂量给药的方法在IRA血流改善方面优于术中冠脉内给药,同时不增加出血风险。Objective To investigate the curative effect and safety of preoperative tirofiban combined with intraoperative small dose intraeoronary administration in emergency pereutaneous coronary intervention （PCI） surgery. Methods A total of 102 patients with acute ST-segment elevation myocardial infarction （STEMI） were randomly divided into research group （52 cases） and control group （50 cases）. Tirofiban was given to the research group before operation, while not to the control group. Comparisons were made on spontaneous reeanalization rate of infarction related artery （IRA）, incidences of slow flow and no-reflow in PCI, and incidences of major adverse cardiovascular events （MACE） and bleeding events in 7 d after PCI between the two groups. Results The research group had higher spontaneous recanalization rate of IRA showed by coronary angiogram than the control group, and its incidences of slow flow and no-rcflow were lower than the control group. The differences between the two groups had statistical significance （P〈0.05）. The research group had lower incidence of MACE events in 7 d after surgery than the control group, but their difference had no statistical significance （P〉0.05）. Both groups had no severe bleeding events. Conclusion Preoperative tirofiban combined with intraoperative small dose intracoronary administration in emergency PCI surgery provides better effect in improvement of IRA flow than intraoperative intracoronary administration, without risk of bleeding as well.

关 键 词：急性心肌梗死 介入治疗 替罗非班 

分 类 号：R542.22[医药卫生—心血管疾病]