自制给药系统冠状动脉内注射替罗非班对急性心肌梗死再灌注疗效的影响  

Effect of intracoronary tirofiban injection using a homemade balloon delivery system with side holes on the reperfusion in patients with acute myocardial infarction

作　　者：张雁[1] 吴弘[1] 孙育民[2] 周贇[2] 王骏[2] 黄少华[2] 徐志强[2] 陶文其[2] 俞帅[2] 连敏[2] ZHANG Yan WU Hong SUN Yumin ZHOU Yun WANG Jun HUANG Shaohuo XU Zhiqiang TAO Wenqi YU Shuai LIAN Min(Department of Cardiology, Changhai Hospital Affiliated to Second Military MedicalUniversity, Shanghai 200433 Departmert of Cardiology,Jingan District Centre Hospital of Shanghai,Shanghai 200040 , China)

机构地区：[1]第二军医大学附属长海医院心内科,上海200433 [2]上海市静安区中心医院心内科,200040

出　　处：《国际心血管病杂志》2017年第3期185-188,共4页International Journal of Cardiovascular Disease

基　　金：中国医师协会阳光心血管研究基金(SCRFCMDA201225)

摘　　要：目的:观察急诊经皮冠状动脉介入术(PCI)自制带侧孔球囊给药系统冠状动脉(冠脉)内注射替罗非班对急性ST段抬高型心肌梗死(STEMI)的疗效以及短期临床预后的影响。方法:53例接受急诊PCI的STEMI患者,随机分为经指引导管冠脉内注射替罗非班组(对照组,n=27)和经自制带侧孔球囊给药系统冠脉内注射替罗非班组(试验组,n=26)。对比不同给药方法对疗效的影响。结果:试验组未发生与自制带侧孔球囊相关并发症。两组在球囊扩张、血栓抽吸、注射替罗非班后心肌梗死溶栓试验(TIMI)3级血流、校正TIMI计帧数以及心肌染色分级0~1级例数的差异无统计学意义(P均>0.05)。住院期间两组各死亡1例。随访1年,两组各发生心力衰竭2例和再发心绞痛1例。结论:自制带侧孔球囊给药系统可以安全地应用于STEMI患者急诊PCI,经该系统冠脉内注射替罗非班对短期临床预后无明显影响。Objective：To evaluate the effect of intracoronary tirofiban injection using a homemade balloon delivery system with side holes on the reperfusion in patients with acute ST-segment elevated myocardial infarction（STEMI）during emergency percutaneous coronary intervention（PCI）procedure and its impact on short-term clinical prognosis. Methods：Fifty-three STEMI patients who underwent emergency PCI were randomly divided into two groups：intracoronary tirofiban injection by guiding catheter group（control group,n=27）,and intracoronary tirofiban injection by homemade balloon delivery system with side holes group（study group,n=26）.The effects of the two different methods on the treatment results were compared. Results：No complications related to the homemade balloon delivery system occurred in the study group.Differences in the myocardial infarction（TIMI）grade 3blood flow,corrected TIMI frame counting and myocardial blush grade 0~1 after balloon dilatation,thrombus aspiration,and tirofiban injection between the two groups were not statistically significant（all P〉0.05）.One case died during hospitalization in each of the two groups.Two cases of heart failure and1 case of angina occurred during the 12-months follow-up in each group. Conclusion：The homemade balloon device with side holes can be safely used for emergency PCI in acute STEMI patients,but tirofiban coronary injection using the balloon device shows no noticeable effect on short-term prognosis.

关 键 词：心肌梗死 经皮冠状动脉介入术 替罗非班 再灌注 

分 类 号：R542.22[医药卫生—心血管疾病]