经皮冠状动脉介入联合依替巴肽治疗急性ST段抬高心肌梗死患者的疗效观察  

Effect of primary percutaneous coronary intervention combined with eptifibatide on patients with STsegment elevation myocardial infarction

作　　者：王慧敏[1] 刘超[1] 储毓舜[1] 赵彦叶 Wang Huimin;Liu Chao;Chu Yushun;Zhao Yanye(Department of Cardiology,Affiliated Hospital of Chinese people's Armed Police Force College,Tianjin 300163,China)

机构地区：[1]中国人民武装警察部队后勤学院附属医院心内科,天津300163

出　　处：《中国循证心血管医学杂志》2018年第12期1463-1465,1470,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：国家自然科学基金资助项目(81102088;81441101; 81570335)

摘　　要：目的评价经皮冠状动脉介入术(PCI)联合依替巴肽治疗急性ST段抬高心肌梗死(STEMI)患者的疗效及安全性。方法选取中国人民武装警察部队后勤学院附属医院于2016年10月～2017年10月收治的102例STEMI患者,随机分为研究组与对照组,每组各51例。对照组常规行PCI治疗,研究组在常规PCI治疗基础上给予依替巴肽,比较两组患者术后TIMI血流分级、校正的TIMI血流帧数(cTFC)、ST段回落情况,血小板聚集率,出血事件等。结果与对照组相比,研究组治疗后的TIMI 3级病例较多,差异具有统计学意义(P<0.05);研究组CTFC值为(18.37±2.40),对照组为(20.93±2.65),研究组CTFC值小于对照组,差异有统计学意义(P<0.05);治疗后ST段回落优于对照组,差异有统计学意义(P<0.05);对照组血小板聚集率术前、术后及停药后无显著改变;研究组术后及停药后2 h血小板聚集率均较术前有明显下降,且较对照组同时段降低,差异有统计学意义(P<0.05);研究组出血事件、血小板减少及术后30 d主要不良心血管事件发生率与对照组相比,差异无统计学意义(P>0.05)。结论 PCI联合依替巴肽治疗策略具有良好的治疗效果及安全性。Objective To investigate the efficacy and safety of primary percutaneous coronary intervention combined with eptifibatide on patients with ST-segment elevation myocardial infarction(STEMI).Methods 102 STEMI patients in Affiliated Hospital of Logistics College of the Chinese people's Armed Police Force from October 2016 to October 2017 were selected and randomly divided into the study group and the control group,with 51 patients in each group.The control group was treated with PCI,and the study group was treated with eptifibatide on the basis of the control group.The postoperative TIMI blood flow grading,corrected TIMI frame count(cTFC),ST segment fallback,platelet aggregation rate,and bleeding events were compared between the two groups.Results Compared with the control group,there were more TIMI grade 3 cases in the study group,and the difference was statistically significant(P<0.05).The CTFC value of the study group(18.37±2.40)was smaller than that of the control group(20.93±2.65),and the difference was statistically significant(P<0.05).After treatment,the ST segment was better than the control group,and the difference was statistically significant(P<0.05).Platelet aggregation rate in the control group did not change significantly before,after,and after withdrawal.The platelet aggregation rate of the study group was significantly lower than that of the control group 2 h after the operation and the drug was stopped,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of major adverse cardiovascular events between the study group and the control group at 30 days after surgery(P>0.05).Conclusion Percutaneous coronary intervention combined with eptifibatide has a good therapeutic effect and safety.

关 键 词：急性ST段抬高心肌梗死 冠状动脉介入治疗 依替巴肽 

分 类 号：R542.22[医药卫生—心血管疾病]