替罗非班和硝普钠冠状动脉内灌注联合血栓抽吸导管在急性心肌梗死介入治疗中的应用  

Application of intracoronary perfusion of tirofiban and sodium nitroprusside combined with thrombus aspiration catheter in interventional therapy of acute myocardial infarction

作　　者：陈千生 方勇 CHEN Qiansheng;FANG Yong(Department of Cardiology,Longyan First Hospital Affiliated to Fujian Medical University,Fujian,Longyan 364000,China)

机构地区：[1]福建医科大学附属龙岩第一医院心内科,福建龙岩364000

出　　处：《中国医药科学》2020年第20期186-188,191,共4页China Medicine And Pharmacy

摘　　要：目的探讨替罗非班和硝普钠冠状动脉内灌注联合血栓抽吸导管在急性心肌梗死介入治疗中的应用价值。方法选取我院2019年1~12月收治的急性心肌梗死合并急性完全闭塞病变患者273例,根据治疗方式,将患者分为三组,实验A组115例采用单纯球囊扩张术后植入支架治疗,实验B组116例在实验A组基础上增加导丝通过病变后冠状动脉内注入替罗非斑和硝普钠治疗,实验C组42例在实验B组基础上联合抽吸导管治疗。比较三组患者术后无复流、即刻手术效果、术后1个月心功能情况。结果实验C组术后无复流发生率较实验B组、实验A组低,但差异无统计学意义(P>0.05);实验C组即刻手术成功率较实验B组、实验A组高,但差异无统计学意义(P>0.05);实验C组术后1个月左心室射血分数(LVEF)高于实验B组、实验A组,差异有统计学意义(P<0.05)。实验组C左心室舒张末期内径(LVEDD)低于实验B组、实验A组,差异有统计学意义(P<0.05)。结论替罗非班和硝普钠冠状动脉内灌注联合血栓抽吸导管在急性心肌梗死介入治疗中可提高即刻手术成功率,改善近期心功能情况,临床应用效果显著。Objective To investigate the application value of intracoronary perfusion of tirofiban and sodium nitroprusside combined with thrombus aspiration catheter in interventional therapy of acute myocardial infarction(AMI).Methods A total of 273 patients with AMI complicated with acute complete occlusion admitted to our hospital from January to December 2019 were selected and divided into three groups according to the treatment methods.115 patients in the experimental group A were treated with stent implantation after balloon dilatation,116 patients in the experimental group B were treated with intracoronary perfusion of tirofiban and sodium nitroprusside after the guide wire passed through the lesion on the basis of the experimental group A,and 42 patients in the experimental group C were treated with aspiration catheter on the basis of the experimental group B.Differences in the three groups of patients with no postoperative reflux,immediate surgery efficacy and cardiac function at 1 month after operation were compared.Results The incidence of noreflow after operation in the experimental group C was lower than those in the experimental group B and the experimental group A,and there were no statistically significant differences between groups(P>0.05).The success rate of immediate surgery in the experimental group C was higher than those in the experimental group B and the experimental group A,and there were no statistically significant differences between groups(P>0.05).The left ventricular ejection fraction(LVEF)of the experimental group C was higher than those of the experimental group B and the experimental group A at 1 month after operation,and there were statistically significant differences(P<0.05).The left ventricular end diastolic diameter(LVEDD)of the experimental group C was lower than those of the experimental group B and the experimental group A,and there were statistically significant differences(P<0.05).Conclusion The application of intracoronary infusion of tirofiban and sodium nitroprusside combined wi

关 键 词：替罗非班 硝普钠 冠状动脉内灌注 血栓抽吸 急性心肌梗死 介入治疗 

分 类 号：R542.2[医药卫生—心血管疾病]