急性心肌梗死患者PCI术中替罗非班冠状动脉内直接给药短期效果及其对血小板微粒的影响  

Short term effects of intracoronary administration of tirofiban and its effect on PMPs in patients with acute myocardial infarction

作　　者：刘芳[1] 王丽萍[1] 刘首宏 

机构地区：[1]大连大学附属新华医院心血管内科,大连116021

出　　处：《中国循证心血管医学杂志》2017年第12期1516-1518,共3页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的探讨急性心肌梗死PCI术中替罗非班冠状动脉(冠脉)内直接给药短期效果及其对患者血小板微粒(PMPs)影响。方法纳入2014年12月~2016年12月于大连大学附属新华医院心内科接诊的98例急性心肌梗死患者,随机分为试验组和对照组两组,每组各49例。相同常规治疗条件下,试验组患者PCI治疗过程中替罗非班冠脉内直接给药,对照组采用静脉持续泵注替罗非班。比较两组患者TIMI血流分级、TMPG血流分级、术后PMPs水平和再出血情况。结果对照组患者术后TIMI 0~2级占51.02%,TIMI 3级占48.98%,而试验组患者TIMI 0~2级占20.41%,TIMI 3级占79.59%。术后的TMPG血流分级比较中,对照组患者0~2级占46.94%,3级占53.06%,试验组患者0~2级占26.53%,3级占73.47%。术后患者PMPs水平与再出血情况比较中,试验组患者PMPs为(6.7±2.1)%,出现轻度出血的患者所占比例为6.12%(3/49),重度出血为2.04%(1/49),明显低于对照组患者(8.3±3.5)%,12.24%(6/49)和6.12%(3/49),差异具有统计学意义(P<0.05)。结论急性心肌梗死患者在PCI治疗中替罗非班冠脉内直接给药可在短期内改善急性心肌梗死患者PCI术后梗死相关血管的TIMI血流,并可降低PMPs水平。Objective To investigate the short-term effect of tirofiban intracoronary direct administration and its effect on platelet microparticles （PMPs） in patients with acute myocardial infarction （AMI）. Methods The study included 98 AMI patients （including ST segment elevation or non-ST segment elevation） admitted to the Department of Cardiology of Xinhua Hospital of Dalian University from December 2014 to December 2016. The patients were divided into the experimental group and the control group. Besides routine treatment, the patients in the experimental group were given direct administration of tirofiban in the coronary artery during percutaneous coronary intervention （PCI）, and the control group was treated with intravenous continuous infusion. The TIMI blood flow classification, TMPG blood flow classification, postoperative PMPs level and rebleeding were analyzed and compared between two groups. Results In the control group, TIMI 0~2 accounted for 51.02%, TIMI 3 accounted for 48.98%. In the experimental group, TIMI 0~2 accounted for 20.41%, TIMI 3 accounted for 79.59%. In the control group, 46.64% of the patients were TMPG grade 0~2 and 53.06% were grade 3. In the experimental group, 20.41% of the patients were TMPG grade 0 ~ 2 and 79.59% were grade 3. The level of PMPs of the experimental group was （6.7±2.1）%, the proportion of mild hemorrhage in the experimental group was 6.12% （3/49）, and the ratio of severe bleeding was 2.04% （1/49）, which was significantly lower than that of the control group （8.3±3.5）%, 12.24% （6/49） and 6.12% （3/49）, the difference was statistically significant （P〈0.05）. Conclusion Intracoronary administration of tirofiban in patients with acute myocardial infarction during PCI treatment has a certain effect on the remission of coronary artery thrombosis in the short term, and can reduce the level of PMPs in patients with acute myocardial infarction.

关 键 词：急性心肌梗死 替罗非班 冠状动脉给药 静脉泵注 

分 类 号：R542.22[医药卫生—心血管疾病]