替罗非班治疗比伐卢定抗凝下急性ST段抬高性心肌梗死经皮冠状动脉介入术中无复流或慢血流  

Effects of tirofiban on no- reflow or slow flow in acute ST segment elevation myocardial infarction undergoing percutaneous coronary intervention with bivalirudin anticoagulation

作　　者：姜海兵[1] 李岚[1] 葛振嵘[1] 徐风燕[1] 马骏[1] 沈祥礼 姜述斌[1] 

机构地区：[1]新疆医科大学附属中医医院心脏中心CCU,新疆乌鲁木齐830000

出　　处：《中国新药与临床杂志》2015年第11期884-888,共5页Chinese Journal of New Drugs and Clinical Remedies

摘　　要：目的观察替罗非班对急性ST段抬高性心肌梗死(STEMI)患者在比伐卢定抗凝下直接经皮冠状动脉介入治疗(PCI)中出现无复流或慢血流的疗效。方法 87例STEMI患者在比伐卢定抗凝下直接PCI术中出现无复流或慢血流,均给予硝酸甘油冠脉内推注,仍无复流或慢血流的患者随机冠脉内给予替罗非班10μg·kg-1(治疗组,n=44)或肝素盐水20 m L(8 U·m L-1,对照组,n=43),于给药后5 min时复查造影,观察两组梗塞相关血管的TIMI血流分级(TFG)和校正的TIMI血流帧数计数(CTFC)、出血并发症和30 d主要心血管事件(MACE)。结果给药后5 min两组TFG、CTFC比给药前显著好转(P<0.05),治疗组优于对照组(P<0.05)。两组术后出血并发症和30 d MACE发生率无显著差异(P>0.05)。结论对于STEMI患者在比伐卢定抗凝下直接PCI术中出现无复流或慢血流,冠脉内给予替罗非班效果明显且安全。AIM To observe the efficacy of tirofiban on no- reflow or slow flow in acute ST segment elevation myocardial infarction （STEMI） undergoing percutaneous coronary intervention （PCI） with bivalirudin anticoagulation. METHODS Eighty-seven patients of STEMI patients in treatment with to PCI and bivalirudin anticoagulation were given nitroglycerin pulse within bolus, still no- reflow or slow. The patients randomized intraeoronary given tirofiban 10 μg .kg-1 （treatment group, n = 44） or heparin saline 20 mL （8 U.mL-1, control group, n = 43 ）. After 5 min, the infarct- related artery TIMI flow grade （TFG） and corrected TIMIframe count of blood flow （CTFC） were reviewed angiography, and major bleeding complications and 30 d cardiovascular events （MACE） were observed. RESULTS The TFG and CTFC of two groups were significantly better than the pre-dose after 5 min （P 〈 0.05）, and the treatment group was better than the control group （P 〈 0.05 ）. There was no significant difference of bleeding complications and 30 d MACE between the two groups （P 〉 0.05 ）. CONCLUSION For patients with STEMI no- reflow or slow flow, the efficacy of intracoronary tirofiban is obvious and safe under the direct PCI with bivalirudin anticoagulation.

关 键 词：替罗非班 比伐卢定 心肌梗死 冠状动脉 无复流 

分 类 号：R973.2[医药卫生—药品]