替罗非班在急性ST段抬高型心肌梗死冠脉介入手术治疗中对血流动力学的影响  

Effect of tirofiban on hemodynamics in the treatment of acute ST segment elevation myocardial infarction by coronary intervention

作　　者：骆嵩山 覃丽萍[1] 杨红英 宋雯雯[1] 程俊[1] 谭军源 LUO Song-shah ,TAN Li-ping, YANG Hong-ying, SONG Wen-wen, CHENG Jun ,TAN Jun-yuan(The People＇s Hospital of Yingde City, Qingyuan 513000, China)

机构地区：[1]英德市人民医院心血管内科,广东英德513000

出　　处：《泰山医学院学报》2018年第7期746-748,共3页Journal of Taishan Medical College

基　　金：清远市科技计划项目(170804181900789)

摘　　要：目的探讨不同剂量替罗非班在急性ST段抬高型心肌梗死(STEMI)冠脉介入手术治疗中对血流动力学及术后心电图改变、胸痛缓解情况的影响。方法将2016年1月—2018年4月期间来我院接受治疗的80例STEMI患者选为观察对象,依照随机数字表法分为两组,即低剂量组(n=40)、标准剂量组(n=40)。低剂量组患者给予低剂量替罗非班(5μg/kg)治疗,标准剂量组患者给予标准剂量替罗非班(10μg/kg)治疗,对两组患者术后梗死相关血管(IRA)心肌梗死溶栓(TIMI)血流分级、主要心血管不良事件(MACE)、心电图ST段回落超50%比率、胸痛缓解率及出血分级情况进行统计比较。结果低剂量组患者与标准剂量组患者的TIMI血流分级、MACE发生率、心电图ST段回落比率超50%、胸痛缓解率比较,差异无统计学意义(P>0.05)。低剂量组患者出血率明显低于标准剂量组患者,且出血分级明显轻于标准剂量组患者,比较差异有统计学意义(P<0.05)。结论在STEMI冠脉介入手术治疗中,低剂量替罗非班与常规剂量替罗非班的治疗效果相当,而前者能够减少出血事件的发生,减轻出血分级,值得临床应用与推广。Objective： To investigate the effects of different doses of tirofiban on hemodynamics and postoperative electrocardiogram changes and chest pain relief in patients with acute ST segment elevation myocardial infarction（STEMI） undergoing percutaneous coronary intervention. Methods： Eighyt cases of STEMI treated in our hospital from January 2016 to April2018 were selected as the observation subjects. According to the random number table,they were divided into two groups,namely,the low dose group（n = 40） and the standard dose group（n = 40）. The low dose group were treated with low dose tirofiban（5 g/kg） treatment,the standard dose group was treated with standard dose tirofiban（10 g/kg）. Statistical comparison of infarct related artery after operation in the two groups（IRA） thrombolysis in myocardial infarction（TIMI） flow classification,major adverse cardiovascular events（MACE） over 50%,the resolution of ST segment ratio,chest pain and bleeding rate of classification were made. Results： There was no significant difference in TIMI blood flow grade,MACE incidence and ST segment fall rate between the low dose group and the standard dose group（P〈0. 05）. The difference between the two groups was not statistically significant（P〉50%）. The bleeding rate of the low dose group was significantly lower than that of the standard dose group,and the bleeding grade was significantly lighter than that of the standard dose group. The difference was statistically significant（P〈0. 05）. Conclusion： Low dose tirofiban is the same as regular dose of tirofiban in STEMI percutaneous coronary intervention,while the former can reduce the occurrence of bleeding events and reduce bleeding grades,which is worthy of clinical application and promotion.

关 键 词：急性ST段抬高型心肌梗死 冠脉介入手术 替罗非班 血流动力学 心电图 

分 类 号：R541[医药卫生—心血管疾病]