血栓抽吸导管联合冠脉内注射替罗非班对急性心梗患者PCI中的疗效及安全性  

Therapeutic effect of thrombus aspiration catheter combined intracoronary tirofiban injection on AMI patients undergoing PCI and its safety

作　　者：韩羽[1] 

机构地区：[1]黑龙江省大庆龙南医院心内科,黑龙江大庆163457

出　　处：《心血管康复医学杂志》2018年第1期58-61,共4页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探讨血栓抽吸导管联合冠脉内注射替罗非班对急性心肌梗死患者经皮冠脉介入(PCI)术的疗效及安全性。方法:选择124例PCI治疗的急性心肌梗死患者,随机分为血栓抽吸组(62例,采用单纯血栓抽吸导管行PCI),联合治疗组(62例,采用血栓抽吸导管联合冠脉内注射替罗非班进行PCI治疗),对比两组临床疗效、不良事件发生情况。结果:PCI治疗后,与血栓抽吸组比较,联合治疗组左室射血分数[术后30d:(51.04±6.66)%比(62.87±8.12)%]明显提高,左室舒张末期内径[术后30d:(53.78±5.19)mm比(43.89±5.24)mm]和左室收缩末期内径[术后30d:(42.18±4.09)mm比(30.85±4.98)mm]明显减小;肌酸激酶[(161.85±3.74)U/L比(132.54±3.85)U/L]、肌酸激酶同工酶[(32.58±1.30)U/L比(29.45±1.24)U/L]、乳酸脱氢酶[(304.58±3.14)U/L比(241.95±2.14)U/L]和天冬氨酸氨基转移酶[(204.54±3.57)U/L比(165.47±2.48)U/L]水平明显降低;手术成功率(82.26%比100%)、ST段回落率(74.19%比88.91%)均明显提高(P<0.05或<0.01),两组大出血、心脏事件发生率无显著性差异(P均>0.05)。结论:急性心肌梗死患者PCI手术中应用血栓抽吸导管联合冠脉内注射替罗非班可显著提高手术成功率、ST段回落率,改善心功能及心脏结构,且具有良好的安全性。Objective： To explore therapeutic effect of thrombus aspiration catheter combined intracoronary tirofiban injec- tion on patients with acute myocardial infarction （AMI） undergoing percutaneous coronary intervention （PCI） and its safety. Methods： A total of 124 AMI patients undergoing PCI were selected, randomly divided into thrombus aspiration group （n = 62, received PCI with pure thrombus aspiration catheter） and combined treatment group （n = 62, received PCI with thrombus aspiration catheter combined intracoronary tirofiban injection）. Therapeutic effect and incidence of adverse e- vents were compared between two groups. Results： Compared with thrombus aspiration group after PCI, there was significant rise in left ventricular ejection fraction [-30d after PCI.. （51.04 ± 6. 66） % vs. （62. 87 ± 8. 12） %], and significant reductions in left ventricular end- diastolic dimension [30d after PCI： （53. 78 ± 5. 19） mm vs. （43.89 ± 5. 24） mm] and left ventricular end - systolic dimension E30d after PCI： （42.18 ± 4.09） mm vs. （30. 85 ± 4.98） mm] ; significant reductions in levels of creatine kinase [CK, （161.85 ± 3. 74） U/L vs. （132. 54 ± 3.85） U/L], CK isoenzyme MB [ （32. 58 ± 1.30） U/L vs. （29.45 ± 1.24） U/L], lactate dehydrogenase [ （304. 58 ± 3.14） U/L vs. （241.95 ± 2.14） U/L] and aspartate transaminase [- （204. 54 ± 3. 57） U/L vs. （165. 47 ± 2.48） U/L], and significant rise in success rate of PCI （82.26% vs. 100%） and ST regression rate （74. 19% vs. 88. 91%） in combined treatment group, P〈0. 05 or 〈0. 01. There were no significant difference in incidence rates of massive hemorrhage and cardiac events between two groups （P〉0.05 both）. Conclusion： Thrombus aspiration catheter combined intracoronary tirofiban injection during PCI can significantly increase success rate of PCI and ST regression rate, improve cardiac function and cardiac structure with good safety in AMI patients.

关 键 词：血管成形术 气囊 冠状动脉 心肌梗死 血栓形成 

分 类 号：R542.22[医药卫生—心血管疾病]